Blog Page of The Pharmacy at Wellington

Arkansas Drug Take Back

Wed, 22 Apr 2026 22:52:45 GMT

April 2026

We are an official collection site for Arkansas Drug Take Back. From 10 am to 2 pm on Saturday, April 25, 2026 , you can drop off your unwanted medications, securely and anonymously, at The Pharmacy at Wellington.

Let's do our part to keep unused prescriptions and over-the-counter medications out of the wrong hands. By not flushing medications and supplements down the toilet, we also help to keep Arkansas' water clean.

To note, in case you cannot make that day / time, we have a permanent unwanted medication drop off box in the pharmacy.

Medicine or candy?

Speaking of drug safety, it is relevant to note that vitamins and supplements are considered medications and should not be given to children as a treat, even though some vitamins are made to look and taste like candy.

Some of you may have noticed this poster, from the Arkansas Poison Control Center, at The Pharmacy:

Although certain medications may resemble candy, we know that taking them by accident can potentially be very dangerous. If you have a poison emergency, please call the Poison Control Center immediately. They are available 24/7 and in Arkansas, they are part of the UAMS School of Pharmacy.

Their phone number is 1-800-222-1222 .

They can answer questions about all sorts of chemicals:

medications
household chemicals
pool chemicals
creams, lotions, and other personal use chemicals
chemicals that have been mixed
fumes from chemicals
etc.

The experts at the Poison Control Center can direct you on the appropriate steps to take, whether a chemical has been ingested, in contact with your skin, inhaled, in your eye, etc.

Prevention tips

Medication packaging may be child resistant; it is not necessarily childproof (or pet proof!). The best way to keep accidents from happening is to keep medications up high where children cannot reach, see, or access them.

Similarly, when traveling, put away prescription and over-the-counter medications so that they cannot be accessed by other people or pets.

As far as summer chemicals, a good precaution to take when using bug spray is to keep it away from the face (eyes, nose, mouth). Washing our hands before eating is recommended, as is taking a shower once we're home.

Teach children that eating wild plants isn't a good idea. They should always show a trusted adult what the wild plant is before considering eating it.

When using gardening or yard chemicals, following instructions on the packaging will ensure safe handling, as would wearing protective gear (gloves, long sleeves and long pants, a mask). Putting away kids' and pets' toys prior to spreading such chemicals is also good practice.

Finally, because certain chemicals can be dangerous if mixed (for example, chemicals used in pools), keep all chemicals, including medications and over-the-counter drugs, in their original container.

Keep in mind that chemicals can be poisonous if they're used in the wrong way, in the wrong amount, or by the wrong person.

Incidentally, our pharmacist and co-owner Brittany worked at the Arkansas Poison Control Center early on in her career -- she knows first-hand the painful situations that taking preventive steps can avoid!

If you have any questions related to poisons, please don't hesitate to call the Arkansas Poison Control Center.

We wish you a fun and safe summer!

Women's Health

Fri, 27 Mar 2026 19:38:15 GMT

By Jenny Wells, PharmD

March 2026

While we acknowledge International Women's Day on March 8th every year, we would also like to contribute to positive change, in this case by providing information. Jenny Wells, our Pharmacist-in-Charge, takes a special interest in women's health and in this month's blog, she points to two areas where women can take control (in one case plan, and in the other, prevent), rather than having to react to health situations.

The topic of planning pregnancies is relevant for Arkansas since our state has very high teen birth rates compared to national averages. In Arkansas-focused reporting, teen pregnancy/childbearing is explicitly described as linked to poverty and lower educational attainment. Girls who fall pregnant are not just a statistic and every family story is different. We would like to contribute to girls' futures by providing information that they can act on, for their own lives and for our community.

This blog is written to address women, but this information is just as relevant for men, and we hope that it may lead to conversations with loved ones, regardless of gender. At the end of the day, women's health touches families and friends, not just women.

Women's Health

Two women's health topics, which we will discuss in this blog, come with opportunities for you to make health decisions rather than to just be in reactive mode:

Planning pregnancies
Preventing HPV-related cancers

Women's health is about protecting your future -- your health, your goals, and, if you want them, your plans for a family -- on your timeline.

Pregnancy Planning

Having a baby, changes a life, as they say, and I confirm this from first-hand experience! I can also confirm that it would be a huge challenge for a teenager to have a baby, try to continue studying while taking care of her baby, manage relationships, and determine how to support herself and her child.

There is an alternative, where you can plan if and when you become pregnant, stacking the chances in your favor, of:

Better education and training for self-fulfillment and for financial stability;
Providing better life opportunities for your child; and
Being able to better support yourself and your family and reaching your financial goals.

You can reach out to talk with health professionals like your doctor or pharmacist. Health professionals can describe the various planning options, including contraception, and explain them and their benefits and drawbacks in a way that you can understand. They are able to cover topics such as planning the number and/or spacing of children, how to get your body ready for pregnancy, how pregnancy can affect your health and any medical conditions you may have, what you can do to have the smoothest pregnancy possible and the healthiest baby possible, etc. Many different scenarios exist so it is best to reach out and find out more for your specific situation.

Reach out to your primary care doctor or women’s health practitioner first. S/He should be a key part of a pregnancy medical team, and routine checkups and screenings with her/him are vital. If you are unable to get an appointment or need information quickly, in Arkansas, pharmacists trained in women's health can help.

If you're 18+ and need birth control, we as pharmacists can meet with you to discuss options that you qualify for. If you decide to start birth control pills, we can do a quick health screening and determine if you're eligible for a prescription. If yes, we can prescribe oral contraceptives and provide the prescription to you, same-day at the pharmacy.

Pregnancy planning is healthcare and we're here as a resource. If you are concerned about the cost of consulting with us, please call us for information.

Preventing HPV-related cancers

Nobody wants to get cancer. The good news is that some cancers are preventable! Cancers related to HPV, or Human Papillomavirus, are one type.

What is HPV? It's the most common viral Sexually Transmitted Infection (STI) in the United States. Even though HPV is highly contagious, it's not always detected because a person can be infected by certain types of HPV and not have any symptoms, sometimes for decades. HPV can also be transmitted via skin-to-skin contact.

Of the over 100 types of HPV, high-risk strains can cause pre-cancerous cell changes, which can lead to cancer later in life, if not treated. This process can take place without symptoms and cervical cancer, which is caused almost exclusively by HPV, can take 20 years or more to develop after an HPV infection. HPV can also cause cancers of:

the mouth and throat,
vulva (female external genitals),
vagina (muscular tube from the vulva to the cervix),
cervix (lower part of the uterus that connects to the vagina),
penis (in men), and
anus.

Every year, more than 39,000 people get HPV-related cancers in the U.S. Some types of HPV can also cause warts and lesions in various parts of the body. While not all HPV strains may lead to cancer later on, it is relevant to know that currently, there is no cure for HPV. A healthy immune system can rid most strains of the virus from our bodies, but not all.

Getting vaccinated against HPV infection is the best way to protect against cervical cancer. The vaccine, Gardasil, works best if it is administered before the first sexual contact, and younger people (teens) respond better to the vaccine than older people (post-teens).

As well, Pap tests, which look for changes in the cervix that might lead to cancer, should be performed regularly by a physician. Also available are HPV DNA tests. Women should discuss these screening options with their physician because regular screening is part of preventing cervical cancer.

It should be noted that males can also contract HPV and that vaccinating boys/men is advantageous for both men and women, as well as for the community. In Australia, an HPV vaccination program was rolled out in 2007 and in 2021, there was not a single documented case of cervical cancer among women under 25 across the country. Their program included vaccinating both girls and boys.

With more than 135 million doses of Gardasil having been distributed in the U.S. alone, there is robust data that supports Gardasil's safety.

It is good to know what to expect when getting Gardasil. Common side effects are typically short-term. Sore arm, dizziness, and/or fainting can occur, so sitting for observation after receiving the vaccine is common.

Routine vaccination for HPV is recommended around ages 11-12 and can start as early as age 9. If a person starts the series at ages 9-14, it's typically a two-dose series. If starting at 15+, it's a three-dose series. Immunocompromised people generally need 3 doses, regardless. Catching up on this vaccine is also possible for adults beyond the teen years.

Gardasil is about cancer prevention later in life -- it's like wearing sunscreen now to prevent skin cancer later.

Questions?

If you have questions, the best place to start is to have a conversation with a healthcare professional. Many people don’t realize pharmacists can now help with some preventive women’s health services in Arkansas. If you want to know more about HPV or Gardasil, you’re due for a refill, starting birth control for the first time, or just want to talk through options, a quick consult can be a convenient first step—especially when doctor's appointments can be hard to schedule.

Disclosure : We support Arkansas Advocates for Children & Families whose mission it is to ensure that all children and their families have the resources and opportunities to lead healthy and productive lives and to realize their full potential. https://www.aradvocates.org/about-us/

Jenny is one of our pharmacists who specializes in women's health and is credentialled to write oral contraceptive prescriptions. Please feel free to call and ask for her or make an appointment for a consultation.

References and Resources

University of Arkansas Student Magazine on why teens become moms
https://hillmag.uark.edu/why-teens-become-moms/
Arkansas Center for Health Improvement on teen pregnancy statistics
https://achi.net/wp-content/uploads/2017/05/Teen-Pregnancy.pdf
KNWA on how a study shows Arkansas has highest teen birth rate in U.S.
https://www.nwahomepage.com/news/study-arkansas-has-highest-teen-birth-rate-in-u-s/
Office on Women's Health on birth control methods (simple overview)
https://www.womenshealth.gov/a-z-topics/birth-control-methods
Arkansas Advocates for Children & Families on teen births
https://www.aradvocates.org/teen-births-a-low-ranking-arkansas-can-actually-change/
Mayo Clinic on HPV infection (graphic photos of example warts)
https://www.mayoclinic.org/diseases-conditions/hpv-infection/symptoms-causes/syc-20351596
The Cleveland Clinic on HPV
https://my.clevelandclinic.org/health/diseases/11901-hpv-human-papilloma-virus
CDC on HPV vaccination
https://www.cdc.gov/hpv/vaccines/index.html
The American Cancer Society on the prevalence of HPV cancer in the U.S.
https://cancer.org
The University of Sydney on Australia being on track to eliminate cervical cancer
https://www.sydney.edu.au/news-opinion/news/2025/11/20/australia-on-track-to-eliminating-cervical-cancer.html

Is it better to write by hand or type?

Thu, 26 Feb 2026 23:43:46 GMT

February 2026

There is a growing body of research that points to writing by hand being better for our brains than typing, but the answer to this question may be more nuanced as we may choose one or the other based on a variety of criteria.

To start with, what do we mean here when we refer to handwriting or typing? Studies have centered around writing with a pen or pencil, but writing with a stylus on a screen can engage the brain in similar ways as handwriting, especially where the technology simulates the feeling of physical touch (haptic technology).

Handwriting involves processing information in the brain and controlling our hand and fingers to perform the physical act of producing letters on the writing surface. Typing involves processing information in the brain and tapping fingers on a keyboard. However, the two processes show very different results under MRI and PET scans.

Typing can be performed much more quickly than handwriting. By comparison, handwriting requires time for multi-sensory integration. Handwriting engages the sensory and visual systems as we look at the letters forming on the page. That feedback helps our brain fine tune coordination of the pressure needed in each finger, as well as the movement of the hand and arm. We continuously monitor and adjust, anticipating the next shape and executing with our motor system.

This takes more time than tapping on a keyboard, which means that when we're taking notes, we can't write things down verbatim, so we must also process the information. We grasp the meaning and organize the information, relating it to what we know already, fitting it into a knowledge structure. We paraphrase, consolidate, and prioritize information when writing. Sometimes we not only write words, but we may draw lines and arrows as we develop conceptual frameworks.

It is not surprising that research has found that students who take handwritten notes retain conceptual information better than students who type their notes. Writers need to process and transform the information, resulting in greater cognitive involvement and deeper learning and retention.

Due to the speed of typing, researchers have also found that note-taking by typing usually happens verbatim, resulting in shallower information processing and the passive use of a lot of working memory. Typing doesn't require the synchronized activity amongst the various parts of the brain as when a person is writing by hand.

In fact, in the research, brain scans show different brain activation patterns. Handwriting activates a broader network of brain regions involved in motor, sensory, and cognitive processing, as well as memory and language, while typing activates mainly motor regions of the brain related to visual processing and repetitive finger movements. Typing relies on procedural memory, which is the memory that allows us to perform tasks (such as tying shoes, reading, riding a bike, typing, etc.) without having to re-learn them.

Researchers believe that for young children, learning to write by hand helps to "bake in" neural patterns that are important for learning later on. Handwriting involves fine motor control, and for children, developing dexterity in the coordination of the small muscles in the fingers is useful in life. Typing involves muscles in the hands and fingers, but the movement, repetitive finger tapping, results in homogenous letters on a screen that don't require visual feedback and motor adjustment to produce. Frequent typing may also mean less developed precision in hand and arm movements.

Writing by hand wins out for our brain, but...

Even though typing may not engage our neural circuits as much and we might not process and retain as much as when we're writing by hand, the answer to whether it is better to write by hand or type can be nuanced. This is because we can find ourselves in a myriad of circumstances and many factors can be considered when choosing one or the other:

Age

For children in the developmental stages of life, the plasticity of their brain promotes learning and adaptation. Learning to write letters (printed or cursive or both) engages the fine motor system to help stimulate growing brains and bodies.

Adults who need cognitive rehabilitation, rehabilitation of fine motor skills, or who want to possibly prevent degeneration by stimulating their brains may want to use the richer process of handwriting more often than typing. Examples include when recovering from stroke or brain injury. To note, changes in handwriting are sometimes observed in people who may have diseases that affect the motor system (i.e. Parkinsons).

At any age, we can learn to augment our handwriting abilities, experimenting with sizes, styles (i.e. calligraphy), colors, etc. Writing by hand, because it is slower than typing, can help us to develop our ideas more fully. It can also lend itself to more creativity.

Time

If we're pressed for time and we don't need to retain the information as well, then typing wins out. The same is true if we need a homogenous result quickly -- typed letters are standardized.

Result / Convenience

Similarly, if we need to have a consistent result that is always legible, typing would be the choice over handwriting.

Add to that the need or convenience of being able to search, edit, and/or share the information online, and typing wins again. In some educational contexts, if the goal is to create a transcription, then typing verbatim is more practical than writing everything by hand. Another idea is to create handwritten notes using the transcription, building on familiarity of the information developed during the transcribing.

Type of task and the context

Writing by hand lends itself better to problem solving and to synthesizing ideas due to its slower pace and our brains encoding the information more deeply than when typing.

The context should be considered as well. With an educational goal where information needs to be processed, learned, and retained, handwriting would be the preferred choice. Where the goal is a creative one, again, handwriting would offer the most opportunity for exploring different ideas, shapes, etc.

In the context of a grocery list or a calendar that needs to be shared with another person, one would choose typing because the information can be typed and edited online and shared instantly.

The variety of software applications is amazing these days. For example, there are apps for brainstorming and for flash cards, activities traditionally done with pen and paper. However, it might make more sense to use a brainstorming app that can be projected onto a screen so that a roomful of people can "be on the same page". Or, creating flash cards online makes it easy to edit and share them amongst a study group. The context should therefore be taken into account.

Accessibility

Sometimes typing is the method of choice due to accessibility considerations. Ergonomic keyboards, desks, and chairs make typing more comfortable.

Conclusion

We hope to have provided some "food for thought" and ideas as to when best to write by hand and when to type.

While researching and writing this blog, we realize the importance of engaging our brains and bodies rather than relying too much on technology. Doing so does take work, but we believe that the benefits are worth it!

References and Resources

National Library of Medicine on The Neuroscience Behind Writing - https://pmc.ncbi.nlm.nih.gov/articles/PMC11943480/

NPR on Why writing by hand beats typing for thinking and learning - https://www.npr.org/sections/health-shots/2024/05/11/1250529661/handwriting-cursive-typing-schools-learning-brain

Scientific American on Why writing by hand is better for memory and learning - https://www.scientificamerican.com/article/why-writing-by-hand-is-better-for-memory-and-learning/

Cornell University on Handwriting vs. Typing - https://blogs.cornell.edu/communityeducation/2025/08/29/handwriting-vs-typing-which-is-better/

Wikipedia on procedural memory - https://en.wikipedia.org/wiki/Procedural_memory

Winter Wonderland

Sat, 24 Jan 2026 15:47:46 GMT

January 2026

Living in the South isn't usually associated with cold weather and shoveling snow, but we know that there have been years when we've received an abundance of snow (i.e. winter 2021! ��️❄️)

We'd like to bring to your attention some practical precautions that can be taken in cold, icy, or snowy weather. In this blog, we'll cover:

Exposure to cold
Tips for shoveling snow

Exposure to Cold

Since prolonged exposure of our skin to cold temperatures can result in frostbite, it makes sense to either stay indoors and avoid the exposure, or to limit time spent exposed and/or bundle up to reduce risk. Bundling up means not only the body and extremities such as fingers and toes, but also the head, face, and ears. It is worth taking such precautions because treating frostbite can be painful. Not to mention, in very serious frostbite cases, if the tissue dies, cannot be saved, and turns black over time (in days to months), amputation is the only solution.

Frostbite occurs when the skin temperature drops below 28.4°F (−2°C). The tissues cool off slowly as ice crystals form in between cells. The other fluid in that space becomes more concentrated and pulls liquid out of surrounding cells by osmosis (where liquid molecules go from a less concentrated solution to a more concentrated solution, equalizing the amount of liquid in the two sides). That dehydrates cells and damages them. Frostbite is essentially frozen tissue.

When frostbite is treated, the rewarming phase causes blisters, skin that is easily broken (crumbles), etc. As blood rushes towards the injury to help repair it, the area swells, which in turn can cause the surrounding blood vessels to contract and tiny blood clots to form. These reactions block blood flow to cells, preventing healing.

Diagnosing frostbite includes assessing the person's exposure to cold temperatures and the changes in their skin that are not completely reversed by rewarming. Since it can take up to 72 hours for these skin changes to manifest, an accurate diagnosis of frostbite severity can take time.

Emergency room staff in climates colder than Arkansas have been treating people for frostbite for decades, but it is only recently (2015-2016) that Dr. Poole (a surgeon) and Dr. Gauthier (a pharmacist) introduced the Yukon Frostbite Protocol (aka Whitehorse Frostbite Protocol), which provides diagnosis guidelines and treatment protocol. Dr. Poole and Dr. Gauthier work in the Yukon, a territory in the north of Canada (at 60.7° N latitude) where temperatures periodically drop to −20°F (−40°C) between November and April. The Yukon Protocol helped to reduce amputation rates at their hospital by 50% during the first five years it was implemented and it now serves as a good public resource for physicians who see cases of frostbite (hopefully not in Little Rock!).

Exposure to cold can also cause hypothermia, which is when the body's core temperature falls below 95°F (97.7°F to 99.5°F is the normal body temperature range). Treating mild hypothermia involves warm drinks, warm clothing, and moving about to create body heat. It is dangerous to let hypothermia worsen because it can get serious enough to cause death.

Thus, if you feel cold while outside, go inside to warm up. Drink warm water, put on warm clothing and/or use a blanket.

Shoveling Snow

Going out to shovel snow and clear the sidewalk, walkway, and/or driveway may be necessary, and if that's the case, we'd like to share with you some ideas and practices from our northern neighbors that help to prevent injury:

Consider whether you are in sufficient physical shape to shovel snow and discuss with your doctor. In general, if you load a 2 lbs plastic shovel with 10 lbs of snow (an average amount) every 5 seconds, you'd move over 120 lbs in one minute. Shoveling for 15 minutes can mean moving 1,800 lbs of snow!

As with any strenuous physical activity, it is best to start gradually (i.e. over weeks) and build up one's strength and ability. Consider that most people who injure themselves shoveling are between 40 and 60 years old who work desk jobs. People who have arthritis or rotator cuff issues will want to think twice before shoveling snow. It is prudent to assess your own physical abilities before launching into shoveling snow.
If you are physically able to shovel snow, warm up before doing so. Use small weights or exercise bands to warm up the arm muscles and shoulders, do leg squats, rotate and stretch the shoulders, lean back and forth to warm up the back, and do a few crunches to warm up the core. This will prepare muscles and raise your heartrate a bit for the workout.
Where possible, shovel soon after snowfall and often. Fresh snow is lighter and hasn't had the chance to get packed down, so it is more manageable than wet or partly melted snow.
Dress appropriately. Wear layers of warm, lightweight clothing that allow movement, and remove layers as you need to keep from sweating. The inner layer should allow perspiration to escape from the skin's surface. Put on footwear that has traction or wear crampons (metal grips) on your shoes or boots to prevent from falling, especially if there is ice under the snow. Use gloves that are flexible and provide a good grip. Wear something over your mouth / face if it is very cold.
Keep hydrated with water even if you're not thirsty and avoid caffeinated drinks as they can put extra stress on the heart. Take stretch breaks. Alternate the side you use to hold the shovel from time to time. Listen to your body because it's not worth getting injured. If you're tired, stop. Shoveling snow uses muscles and also works the heart and cardiovascular system.

Choose a snow shovel because shovels made for other purposes will make the job much harder. A snow shovel is light and sturdy. The top of the handle should reach your chest to reduce the amount of bending. If you have lower back issues but still must shovel snow, use one with a bend in the shaft. To decrease the risk of injury, use a large push-style shovel to shove snow to the side and use a shovel with a smaller blade to lift and throw snow.
Make a plan as to where you want to put the snow so that you don't end up having to move it more than once. Choose a spot where water from the melting snow won't be in a bad location if it refreezes.
As far as shoveling technique, hold the shovel so that your hands and arms are not twisted.

It is better to push snow instead of lifting and throwing it. If you must throw it, take only as much snow as you can lift and turn your feet before throwing. It's ok to lift partially filled loads to keep the weight down. Don't twist at the waist, throw snow over your shoulder, or to the side. Stand with your feet hip-width apart for balance and keep the shovel close to your body. Bend at the knees rather than at the waist if picking up snow.

Be watchful for melted ice beneath the snow that can be slippery. On snow and ice, walk like a penguin, with your toes pointed outward. Bend your knees slightly and put your center of gravity over your heel. Don't put your hands in pockets, take shorter shuffle-like steps, and go slowly.
If you are experiencing an emergency, call 911. Warning signs of a heart attack include jaw pain, arm pain, chest pain, shortness of breath, nausea, pale skin, etc.

Probably the best solution, if you can, is to simply stay indoors and wait it out!

Resources and References:

The Yukon Frostbite Protocol - https://yukon.ca/en/whitehorse-frostbite-protocol

News article about The Frostbite Doctors - https://uphere.ca/articles/frostbite-doctor

National Library of Medicine on the treatment of severe frostbite (including summary of the Yukon Frostbite Protocol) - https://pmc.ncbi.nlm.nih.gov/articles/PMC5135497/

News article about treating frostbite - https://www.cbc.ca/news/canada/north/canadian-frostbite-care-network-treatment-iloprost-yukon-1.7374871

Canadian Centre for Occupational Health and Safety on shovelling snow - https://www.ccohs.ca/oshanswers/ergonomics/snow_shovelling.html

CBC on shovelling snow safely - https://www.cbc.ca/news/canada/london/snow-shoveling-injury-safety-tips-9.7011137

Mayo Clinic for shoveling snow safely - https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/tips-for-safe-snow-shoveling

Wikipedia on hypothermia - https://en.wikipedia.org/wiki/Hypothermia

Dads and healthy babies

Mon, 15 Dec 2025 22:13:28 GMT

December 2025

The dad's contribution to having a baby has more of an effect than previously thought...

The dad's role in making babies is obvious, but there have been recent studies about the impact of the sperm's contributions to a baby's short- and long-term health.

It is well known that children born of mothers who drink during pregnancy are prone to having Fetal Alcohol Syndrome (FAS), which causes various birth defects and developmental delays. The term FAS was first published in 1973, and the first public awareness warning on FAS was issued by the U.S. Food and Drug Administration on June 1, 1977. Today, experts use the term Fetal Alcohol Spectrum Disorder (FASD) instead of FAS, to recognize the wide spectrum of associated symptoms.

FASD babies can be born with abnormal facial features, crossed-eyes, cleft palate, lower-than-average weight, height, or both, speech delays, cognitive and learning problems, incomplete development of genitalia, central nervous system problems, issues with attention and hyperactivity, poor coordination, etc.

Studies about FASD in the past have been focused on the mother, but recent studies have turned attention to the father's role because some mothers with FASD babies do not drink alcohol. The researchers also wanted to bring more balance into their research since both parents contribute to their baby.

For a number of years now, scientists have started to understand that information from the sperm is transferred through epigenetic modifications, which are changes to DNA* that determine whether a gene is activated or not. These modifications are attached to DNA but don't change the sequence of DNA.

Let's start with the genes -- humans have 46 chromosomes, 23 from the mother, 23 from the father. They contain the DNA that give us our phenotype, or our observable traits: eye color, height, hair color, blood type, etc.

It has only been about 15 years since scientist have been aware of epigenetic modifications, which is the effect of the environment on a gene, whether the gene will be activated or not.

So if the sperm transmits epigenetic information to the baby, then the experience of that sperm even before it fertilizes the egg can have an impact on the baby.

THINK TWICE...

Dr. Michael Golding, a researcher at Texas A&M University, and his team showed a link between each of the parents' alcohol consumption and the baby. They used mice** in their laboratory experiments and showed that a baby can be negatively impacted by exposure to alcohol consumption by either parent and that exposure via both parents has the strongest harmful effect.

In addition, Dr. Golding and his team found that male alcohol consumption before conception can cause placenta-related difficulties, including decreased placenta efficiency. Fewer nutrients from the placenta can result in restricted fetal growth, in part because inefficient placentas try to compensate by becoming overgrown.

Results from their studies also point to accelerated aging in individuals where one or both parents consumed alcohol prior to the individuals' birth. Issues such as high cholesterol, heart problems, arthritis, and early onset dementia can become problems, especially in male offspring, as early as in the individuals' 40's.

Other research has shown that male alcohol consumption reduces the father's fertility, including reducing the rate of success in IVF (in-vitro fertilization) procedures. And there is growing scientific interest in how sperm exposure to other products (medications, DDT, etc.) could affect the health of the child. Scientists are working on developing new biomarkers to measure sperm health, to try to identify epigenetic mutations that can have negative effects on a newborn.

While scientists continue to carry out further research, it would be prudent for couples planning to conceive to both refrain from drinking prior to and during pregnancy. Working together to lead a healthier lifestyle can mean building a good foundation for the child because healthy living benefits also get passed on generationally.

Dr. Golding notes that sperm is made during the course of two months and it takes at least a month for an individual's body to go through an alcohol withdrawal process, so his current estimated recommendation for refraining from drinking is at least 3 months prior to conception. Of course, stopping alcohol intake earlier will only bring health benefits earlier!

*DNA is deoxyribonucleic acid, the molecule inside each of our cells that contains our genetic information. It has a double helix structure containing pairs of chemicals referred to as A, T, G, and C.

**Why are mice used? Mice are often used for ethical reasons (it would be unethical to experiment on humans knowing that damage could be done), because mice experience many of the same diseases as humans, these mammals have the same types of organs and bodily systems as humans, they have about 95% of the same genes as us that code for proteins, and because they have short life spans.

References and Resources:

Texas A&M on father's alcohol consumption before conception

https://vetmed.tamu.edu/news/press-releases/fathers-alcohol-linked-to-offspring-defects/

Centers for Disease Control and Prevention Archive page about FASD birth defects

https://archive.cdc.gov/www_cdc_gov/ncbddd/birthdefects/surveillancemanual/photo-atlas/photoatlas.html

Radio-Canada on the effect of the father's drinking habits on newborns

https://ici.radio-canada.ca/ohdio/premiere/emissions/penelope/segments/chronique/480996/sante-procreation-maladie-enfant-parentalite-pere-homme

Children's National on the most common symptoms of FASD

https://www.childrensnational.org/get-care/health-library/fetal-alcohol-syndrome-and-other-teratogens

National Library of Medicine on the history of awareness of the link between alcohol and Fetal Alcohol Spectrum Disorder

https://pmc.ncbi.nlm.nih.gov/articles/PMC6405809/

Science Direct article on the discovery and evolution of FASD

https://www.sciencedirect.com/science/article/abs/pii/S0277953698003086

Children's National on the most common symptoms of FASD

https://www.childrensnational.org/get-care/health-library/fetal-alcohol-syndrome-and-other-teratogens

European Animal Research Association and why mice are used in studies

https://www.eara.eu/mice-and-animal-research

Science Direct article on investigating the association between alcohol intake and male reproductive function

https://www.sciencedirect.com/science/article/pii/S2405844023029304

National Library of Medicine definition of epigenetics

https://medlineplus.gov/genetics/understanding/howgeneswork/epigenome/

Medical Xpress article Male alcohol use may be a crucial, unrecognized factor affecting IVF outcomes

https://medicalxpress.com/news/2023-01-male-alcohol-crucial-unrecognized-factor.html

Medical Xpress article Researcher says men should abstain from drinking at least three months prior to conceiving

https://medicalxpress.com/news/2023-12-men-abstain-months-prior.html

Medical Xpress article New study shows paternal alcohol use increases frequency of fetal development issues

https://medicalxpress.com/news/2022-02-paternal-alcohol-frequency-fetal-issues.html

Medical Xpress article Children can inherit early aging symptoms from parents who abuse alcohol, researchers find

https://medicalxpress.com/news/2024-08-children-inherit-early-aging-symptoms.html

BBC on FAS and why fathers need to watch what they drink too

https://www.bbc.com/future/article/20240801-fetal-alcohol-syndrome-the-overlooked-risk-of-fathers-who-drink

Maximizing your workouts

Sat, 29 Nov 2025 23:15:39 GMT

November 2025

Here's something you can do to maximize the positive effects of your workouts!

In a word, it is to work your brain while doing vigorous exercise, ideally incorporating a cognitive task to a motor task. Research using orienteering have provided this result (more on this below).

We know that researchers have found many, many benefits to physical exercise ("PE"), which is not simply physical activity. Physical activity incorporates everyday movements, while PE is planned, structured, and repetitive aerobic, anaerobic, and resistance exercise, carried out with the intention to improve physical fitness. Below is an overview of some learnings about PE:

PE increases blood flow, providing oxygen and nutrients to cells throughout the body.
PE enhances cognitive functioning, increasing gray matter volume in frontal and hippocampal regions. It is also related to better integration of information between various modules in the brain, enabling faster and more accurate performance on cognitive tasks.
It takes approximately 6 months of PE for related cognitive benefits.
PE improves wellbeing and brings psychological benefits. For example, it decreases anxiety and depression and it increases confidence, emotional stability, positive body image, etc.
PE increases academic achievement, especially in children.
PE helps to prevent cognitive decline in older adults.
For maximum effect on cognitive function, performing PE up to middle life is necessary, although it is never too late to start and maintain PE.
Doing PE outside (for example, taking a walk outside rather than on a treadmill inside) can make an additive positive impact on brain function.
The greatest positive effects of exercise on cognitive functions were found in adults aged 60+.

In research published in May 2024, lead author and kinesiology graduate student at McMaster University Emma Waddington found that engaging your brain while working out can increase the cognitive benefits of exercise. The study also suggests that vigorous exercise (running as opposed to walking) can result in greater cognitive benefit.

Her study examined levels of lactate (previously referred to as lactic acid) and levels of brain-derived neurotrophic factor (BDNF).

BDNF stimulates the growth of new neurons in the hippocampus, a part of the brain that shrinks about half a percent per year by the age of 55. The hippocampus helps with learning, spatial memory, verbal memory, and short- and long-term memory, including the recollection of facts and experiences.

Lactate was once considered the culprit for sore muscles after intense exercising but is now believed to play at least two roles:

to be a fuel for cells throughout the body, including brain cells, and
to send a chemical signal to the brain to activate BDNF, which in turn strengthens connections between brain nerves that happen to be firing.

This implies that what we do with our brain during exercise matters because those are the neural pathways that are reinforced.

The results of this study are in the same vein as previous studies, including:

In 2023, a study led by researchers at Western University found that a mix of aerobic exercise and cognitive training prevented cognitive decline better than exercise alone.
Subjects showed higher scores in attention tests, working memory tests, and cognitive flexibility measures when they were asked to do acute physical exercise with high coordinative (cognitive) demands. (Budde et al., 2008; Koutsandreou et al., 2016; Zach and Shalome, 2016; Benzing et al., 2016)
The combination of physical and cognitive exercise could evoke a higher cognitive enhancement than cognitive or physical exercise alone (Kraft, 2012; Fissler et al., 2013, Bamidis et al., 2014; Lauenroth et al., 2016; Levin et al., 2017; Eggenberger et al., 2015)

It is worthwhile to point out a differentiating factor in the cognitive tasks: those that are unrelated to the physical movement except for being performed at the same time may not provide as much of a benefit as those that are integrated into the physical movement.

Examples of cognitive tasks unrelated to PE could include:

Doing a math problem in one's head while walking, or
Memorizing the names of the planets while running, or
Recalling facts for an upcoming exam during a workout, etc.

In contrast, cognitive tasks integrated into PE such as these can result in increasing the cognitive benefits of exercising:

Remembering the steps while dancing, or
Doing tai chi, which requires remembering movements while performing them, or
Using a map and compass to follow a hiking trail, or
Orienteering, where one races against the clock while navigating through geographical checkpoints with the aid of a map and compass (not a GPS-enabled device). Running orienteering (vigorous PE) garners the most benefit.

We have always known that physical exercise is beneficial -- today's blog offers an idea for trying something new while exercising, for increased benefit!

Please feel free to talk with one of our pharmacists on what starting a physical exercise program means in the context of the medications that you take.

References and Resources:

PLOS One on orienteering and improved human cognition

https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0303785

Globe and Mail on the benefits of engaging your brain during a workout

https://www.theglobeandmail.com/life/health-and-fitness/article-the-benefits-of-engaging-your-brain-during-a-workout/

Cleveland Clinic on the role of the hippocampus

https://my.clevelandclinic.org/health/body/hippocampus

Harvard Health on exercises best for the brain

https://www.health.harvard.edu/mind-and-mood/exercise-can-boost-your-memory-and-thinking-skills

National Library of Medicine on the benefits of Physical Exercise

https://pmc.ncbi.nlm.nih.gov/articles/PMC5934999/

Science Direct on the cognitive benefits associated with exercise variables

https://www.sciencedirect.com/science/article/pii/S1568163723002751

BMC on lactate linking exercise to synaptic protection and cognitive enhancement in Alzheimer patients

https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-025-04168-x

Pfizer on lactate

https://www.pfizer.com/news/articles/science_fact_or_science_fiction_lactic_acid_buildup_causes_muscle_fatigue_and_soreness

Frontiers in Aging Neuroscience on thinking while moving or moving while thinking

https://www.frontiersin.org/journals/aging-neuroscience/articles/10.3389/fnagi.2018.00228/full

Scientific Reports on exercising outside

https://www.nature.com/articles/s41598-022-26093-2

National Library of Medicine: Dove Press Journal Clinical Interventions in Aging about multicomponent physical exercise with simultaneous cognitive training

https://pmc.ncbi.nlm.nih.gov/articles/PMC4631411/

BBC on things you can do to improve your health

https://www.bbc.com/future/article/20251118-things-you-can-do-in-your-30s-to-improve-your-health-in-your-70s

Get your best skin this fall!

Thu, 30 Oct 2025 13:54:11 GMT

October 2025

By Jennifer Spaulding, PharmD

October has arrived, we’ve passed the season of “fake fall” and the crisp breeze has entered the air. Time to pack up the beach bags and begin preparing our skin for the cooler winter months.

While we commonly associate summertime with the months of prioritizing skincare due to increased sun exposure and more revealing clothing, the fall and winter months are just as important in maintaining a healthy skincare routine. The skin is the largest organ in the human body and the first barrier against harmful organisms! A strong skincare routine throughout the whole year is vital to a healthy body.

Some best practices to ensure a healthy skincare routine as we enter the fall:

Use a moisturizing cleanser. It is important to use a cleanser to wash your face, rather than simply water, to ensure that you are opening your pores and cleansing out bacteria that has accumulated throughout the day, to prevent acne and other types of breakouts. There are many cleansers on the market targeted for different skincare needs, and as air temperatures begin to decline and winds begin to pick up, ensure you are using a gentle moisturizing cleanser that is safe for your skin. Use lukewarm water to assist in opening your pores without causing damage through harsh temperatures and your skin will thank you!

Minimize use of certain harsher skincare agents such as salicylic acid and retinoids, unless you have specific skin conditions. Salicylic acid can get deep into pores and help unclog them by removing sebum and other oils that can lead to breakouts, so it can be useful for people who are prone to blackheads and whiteheads.

Products with retinoid are commonly used to treat acne, acne scars, dark spots, large pores, melasma (patchy areas that are brown to gray-brown), psoriasis (a noncontagious autoimmune disease), stretch marks, and wrinkles. However, using retinoid can have undesirable side effects. Our pharmacists can guide you in its use, including during pregnancy or breastfeeding.
Look for certain skincare agents for specific reasons. For example, hyaluronic acid helps bind water to collagen (a structural protein in our skin), thus trapping water in the skin and making it look healthier. Our bodies naturally produce hyaluronic acid, but unfortunately, the production decreases with age.

Another popular anti-aging ingredient is glycolic acid. It is a strong exfoliant which, if used long-term, can boost collagen production. Collagen provides structure and strength to our skin, and again unfortunately, our bodies' natural collagen production decreases with age. It is recommended to start slowly with glycolic acid and ramp up over time if there is no irritation.

Ascorbic acid, also known as the antioxidant vitamin C, helps to fight off free radicals* and is another ingredient found in skincare products. The buildup of free radicals can cause wrinkles, sunspots, and other signs of aging.

Azelaic acid, a gentler ingredient than the facial acids mentioned above, can help to clear redness, rosacea (skin condition of the face that causes flushing or long-term redness), and melasma, and even out skin tone. It is a better choice for people with sensitive skin or for people who are pregnant.

Apply a moisturizer to your body every day. Your skin is the first barrier that external organisms must pass through when attempting to enter your body. If your skin is well hydrated, it becomes more difficult to permeate, thus less penetrable to harmful micro bacteria and viruses. Although your skin may be covered from the elements by clothing, it is still permeable to air and the skin is one of the primary means by which moisture can leave your body. To prevent dehydration, be sure to provide a moisturizer or lotion to your body daily all throughout the year, but especially during the winter when the external elements and dropping temperatures lead to dehydration.

Increase water intake! Water represents 60-75% of the human body at different stages of the human life. Hydration is therefore necessary to healthy skin. Studies have shown that maintaining a higher intake of water outside of water consumed through dietary means leads to a healthier skin barrier, which we have already established can lead to decreased permeation of harmful bacterial agents and viruses. Maintaining a hydrated skin barrier can also decrease the appearance of fine lines and wrinkles.

Always apply sunscreen. Although summertime is over, UV (ultra-violet) exposure can still reach damaging levels throughout the fall and winter months. A daily moisturizer with sunscreen will protect your skin from sun damage. Remember, UV radiation can cause DNA damage, leading to other undesirable conditions.
Lifestyle choices can help. Avoiding tanning beds and not smoking can help keep your skin healthy and not speed up the aging process.

When trying products new to you, consider testing just a little bit of one product at a time on a small area, to ensure that they don't cause irritation or an undesired reaction or result. Also, keep in mind that it might take your skin some time to adjust to a new regimen and that it could take several weeks before results can be seen. Each person's skin is different!

Drop by The Pharmacy and visit with one of our pharmacists about their preferred products to help protect your skin this fall! We can also help with interpreting ingredients lists.

We have an expanded selection of skincare products that we would be happy to help you select from!

*antioxidants are compounds that can counteract unstable molecules called free radicals, which can damage DNA, cell membranes, and other parts of cells.

References and Resources:

American Academy of Dermatology Association

https://www.aad.org/public/everyday-care/skin-care-basics/care/winter-skin-survival-kit

United States Environmental Protection Agency

https://www.epa.gov/sunsafety/sun-safety-monthly-average-uv-index-2006-2023

Cleveland Clinic

https://my.clevelandclinic.org/health/body/10978-skin

Waccamaw Dermatology

https://waccamawdermatology.com/why-you-shouldnt-skip-retinol-this-winter/

Apollo Dermatologu

https://apollodermclinic.com/moisturizers-the-importance-of-moisturizing-as-the-weather-gets-colder/

Harvard Health on antioxidants and free radicals

https://www.health.harvard.edu/staying-healthy/understanding-antioxidants

National Library of Medicine on dietary water affecting skin

https://pmc.ncbi.nlm.nih.gov/articles/PMC4529263/

MDPI on the impact of lifestyle on skin hydration

https://www.mdpi.com/2079-9284/11/1/13

American Academy of Dermatology

https://www.aad.org/public/everyday-care/skin-care-basics/care

Cleveland Clinic

https://health.clevelandclinic.org/guide-to-facial-acids

Cleveland Clinic

https://my.clevelandclinic.org/health/treatments/23293-retinol

Mayo Clinic on the skin (this is a great interview with a dermatologist that covers a lot of information about our skin, products, new technologies, etc. For example, they "myth bust" the ingredient named plant stem cells, which come from the stem of the plant, rather than the stem cells of the plant!)

https://mcpress.mayoclinic.org/living-well/the-skincare-secrets-doctors-do-want-you-to-know-reclaim-skin-health-rejuvenation-and-vibrance/

Eye Care

Mon, 29 Sep 2025 19:06:14 GMT

September 2025

We are pleased to bring you this Guest Blog, written by Grant Morshedi, M.D. He is an ophthalmologist at the Little Rock Eye Clinic, specializing in cataract and glaucoma surgery. We volunteer together with Dr. Morshedi at Harmony Health Clinic.

Maintaining good eye health is critical to a good quality of life. Like other aspects of preventive health practices, getting comprehensive eye examinations is key to early detection of some common eye conditions. At the Little Rock Eye Clinic , our 17 eye doctors provide care for many different eye conditions – ranging from routine vision checks, contact lens or glasses exams, LASIK surgery, and more complex surgical care for conditions such as cataract, glaucoma, and corneal diseases.

What is an eye doctor?

The term “eye doctor” can refer to either an ophthalmologist or optometrist. An optometrist is a Doctor of Optometry (O.D.) who completed 4 years of optometry school following college. Some also then complete a 1-year residency further honing their skills in a specific area of practice. Optometrists are skilled in primary eye care, prescribing glasses and contact lenses, and diagnosing and treating common eye conditions.

An ophthalmologist is a medical doctor (M.D. or D.O.) who graduated from medical school, then completed residency training for 4 years in ophthalmology, sometimes followed by specialty fellowship training for another 1-2 years. Ophthalmologists perform surgical procedures and, depending on their specialty, may also perform primary eye care and prescribe glasses and contact lenses.

Generally, specialists (e.g. glaucoma specialists, cornea specialists, retina specialists, etc.) are ophthalmologists who have completed extra fellowship training to provide comprehensive medical and surgical care for those specific eye conditions within their area of expertise. At the Little Rock Eye Clinic, we have optometrists, comprehensive ophthalmologists, glaucoma specialists, and cornea/refractive surgery specialists.

 When should I get an eye exam?

Some common eye conditions such as refractive errors (myopia, hyperopia, and astigmatism) can occur at any age. Other conditions such as cataract, glaucoma, and macular degeneration are more common among older adults. For this reason, the American Academy of Ophthalmology recommends the following comprehensive eye exam schedule for healthy adults:

Before age 40: comprehensive exam every 5-10 years
Age 40-65: comprehensive exam every 1-5 years, depending on recommendation of doctor
Age 65+: comprehensive exam every 1-2 years

Some adults may need to be seen more frequently than this, depending on their individual eye health or if they have other medical conditions such as diabetes that could affect their eye health.

The goal of comprehensive eye exams is to detect conditions that could affect future eye health and vision – especially conditions where early detection and treatment is key to successful treatment, such as glaucoma and diabetic retinopathy. Many such conditions have little or no symptoms in the early stages, so detection during a routine eye exam is often the only way to be diagnosed and effectively treated.

In the following sections, we’ll briefly review some of the most common conditions that can affect eye health.

Cataract

A cataract is when the natural lens inside the eye becomes cloudy and/or discolored. Clear at birth, the lens helps to refract light rays into a crisp focus on the retina. Throughout life, the lens builds up proteins and metabolic byproducts that affect its clarity, elasticity, and color. Eventually, this leads to vision that is blurry, hazy, less colorful, or cloudy. This often occurs slowly, gradually, and symmetrically between the two eyes so that it may be difficult to detect (similar to how an old shirt gradually fades with repeated laundering, but it’s difficult to notice unless you have a brand new shirt to compare it to).

If a cataract is present but not affecting your quality of life, it doesn’t have to be removed. Sometimes, updating your glasses prescription is enough to improve your vision sufficiently. Cataract surgery is considered when the cataract is affecting the vision in ways that impair your ability to do things that you like to do or need to do (e.g. driving, reading, hobbies). Surgery is often quick (10-15 minutes), painless, and highly successful. It involves removing the cataract and replacing it with an artificial lens implant (intraocular lens or IOL). Once removed, the cataract does not grow back, but it is common to have a hazy lens capsule develop later on that can easily be treated with a laser procedure called capsulotomy.

Glaucoma

Glaucoma is a condition where the optic nerve that connects the eye to the brain gradually gets damaged from elevated eye pressure. It is the leading cause of permanent blindness worldwide, yet it usually begins silently and therefore can only be detected early with a comprehensive eye exam. Blindness from glaucoma can often be prevented with early detection and treatment – which involves lowering the intraocular pressure using medications, lasers, or surgeries. Risk factors for glaucoma include age over 40, certain ethnicities (African, Hispanic, or Asian heritage), certain medications such as steroids, diabetes, previous eye injuries or surgeries, and family history of glaucoma.

Macular degeneration

The full term for this is “age-related macular degeneration,” which highlights the most important risk factor for this disease (aging). More common in patients with family history of the disease, smokers, and patients with hypertension, this condition has 2 main types: “wet” and “dry”. The dry form is more common and typically associated with milder vision loss. The wet form involves leakage of blood or fluid underneath the central part of the retina (the “macula”) and is often treated with injected medications to dry the fluid and slow down the progression of the disease. Patients with macular degeneration often have some degree of central vision impairment, ranging from mild distortion or smudging to a large central blind spot.

For more information about common eye conditions and great tips about common eye health issues, check out the American Academy of Ophthalmology’s EyeSmart website . Visit the Little Rock Eye Clinic website or call (501)224-5658 to schedule your comprehensive eye exam.

Note - We asked Grant Morshedi, M.D. to write this special Guest Blog. Thank you, Dr. Morshedi, for providing this overview on eye care for us and our readers!

Let us know your thoughts on these topics and/or what you'd like to see here!

Rinsing off before getting in a pool

Fri, 29 Aug 2025 16:16:44 GMT

August 2025

Why rinse off before junping in?

What is the science behind this healthy practice? It is essentially to remove impurities on our body that can contaminate the water. For example: perspiration, body oils, cosmetics, lotions, sunblock, topical medications, etc.

In swimming pool water, chlorine binds to those impurities from our bodies, producing chloramines. Chloramines turn into gas in the air above the water and the gas is heavier than air, so it tends to hover on the surface of the pool. At indoor chlorinated pools, this can cause irritation of the skin, eyes, and respiratory tract. A quick rinse before getting into the pool can help a lot to reduce unwelcome bacteria in the pool.

As far as an outdoor pool where there is ample fresh air, showering before getting in reduces the amount of dirt in the pool and gives peace of mind to everyone.

Here are some other good health practices around the pool:

Don't swim or let your kids swim if sick with diarrhea, until two (2) weeks after the diarrhea has stopped. This prevents microscopic bacteria from getting into the pool. For example, if the diarrhea is caused by Cryptosporidium, this parasite has been detected in stool up to two weeks after diarrhea. Chlorine, even in a properly-chlorinated pool, doesn't kill germs instantly, and worse, it doesn't kill cryptosporidium at all. Incidentally, ultraviolet (UV) light and ozone systems do kill cryptosporidium, but ozone pools still need some chlorine in them.
Do your best not to swallow pool water. Avoid activities where pool water might be accidentally swallowed.
Take kids for bathroom breaks often, alleviating the temptation to just go in the pool.
Change diapers in the bathroom rather than poolside. Wash a toddler's bottom and your hands with soap and water when finished.
Rinse off after getting out of the pool.
Wash your hands with soap and water after getting out of the pool because bacteria on the hands can end up being swallowed if you touch your face or food (think barbecue).

Now that we know these precautions to take, let's rinse off, jump in, and enjoy the pool!

References and Resources

Mayo Clinic on cryptosporidium parasite in pools - https://newsnetwork.mayoclinic.org/discussion/infectious-diseases-keep-cryptosporidium-out-of-the-pool/
Mayo Clinic on safe swimming practices - https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-expert-discusses-safe-swimming-practices-to-reduce-water-related-illnesses/
Cleveland Clinic on chlorine cough - https://health.clevelandclinic.org/is-the-chlorine-in-indoor-swimming-pools-hard-on-your-lungs
CDC on chloramines and pool operation - https://www.cdc.gov/healthy-swimming/toolkit/chloramines-and-pool-operation.html
Cleveland Clinic on staying safe from recreational waterborne diseases - https://health.clevelandclinic.org/tips-to-avoid-recreational-water-borne-diseases

Note - Our blog is researched and written by one of us at The Pharmacy, not AI or an external service. Let us know your thoughts on these topics and/or what you'd like to see here!

Sun Protective Clothing

Thu, 24 Jul 2025 22:53:45 GMT

July 2025

Does it really work?

We know that our skin is sensitive to ultraviolet (UV) radiation from the sun and we know that putting on sunscreen, wearing a wide-brimmed hat, etc., are good ways to protect our skin.

This month, we're looking into sun protective clothing and whether it really makes a difference. After all, it is generally more expensive and we like to spend wisely. Here's what we learned...

Clothing does protect our skin from the sun, to varying degrees, based on these factors relating to the clothing itself:

How much of the body's surface area is covered (BSAC) by the piece of clothing;
The fabric it's made of: how tightly woven or knit the fabric is, the type and thickness of the fiber, the thread count, whether it has been chemically treated (i.e. with bemotrizinol, which absorbs UV radiation), and even the color.

A standardized rating scale for the level of sun protection provided by clothing was first developed in Australia in 1996 and has been adopted almost universally by the textile industry. Called the Ultraviolet Protection Factor (UPF), it addresses the second bullet point of factors above (not the first), and it has been implemented in Britain (which now has its own standards scale), Europe, and the U.S.

A new classification scale that simultaneously considers both bullet points above, called the Garment Protection Factor (GPF), has been in use since 2018, although UPF still seems to be more prevalent on labels. Ideally, a label would show the GPF, or failing that, both the UPF and BSAC.

A light-weight fabric would have a UPF of less than 5, for example, and a piece of clothing made of tightly-woven fabric could be rated 40 or 50. UPF measures how much UV radiation penetrates the fabric. Of course, if the piece of clothing only covers a small surface area, it would leave a lot of skin exposed to the sun, which is why GPF is a more comprehensive measure.

The American Skin Cancer Foundation requires a UPF of 50 to qualify for its Seal of Recommendation and fabric that is UPF 50 should block about 98% of UV radiation. This is comparable to a sunblock's sun protection factor (SPF) of 30. Wearing clothing rated at UPF50 doesn't mean being able to forego sunblock, however, since certain areas (especially the face, the hands, the feet, etc.) may not be covered by the clothing and may still be exposed to harmful UV radiation. That's where sunblock can finish the protection job.

Also to note, UPF-rated clothing provides less UV protection when wet or when stretched, so we need to consider our activity and how loosely the clothing fits. The UV protection also wears down with laundering - it depends on the fabric, the sun-protective treatment it may have undergone when it was made, and how frequently it is washed using which wash cycle. Reading the label makes for better-informed decisions.

There are now laundry aids on the market that add sun-protective chemicals to clothes that one owns already, but there has not been sufficient research to show how well they work, or that they don't cause other unintended issues.

Well, there you have it! Our curiosity satisfied for another month, we continue our regular work as pharmacists, answering questions about certain medications and sensitivity to sunlight. Please feel free to drop by, swing by our drive-thru, or call us! We love to hear from you and to help.

References and Resources

James Cook University Australia on body surface area covered by sun-protective clothing - https://wvumedicine.org/camden-clark-health-wellness/project/shower-off-the-yuck/

The first result in this search in Science Direct, from the Chapter on Sun Protection in Man in the book Comprehensive Series in Photosciences by Colin M.H. Dirscoll - https://www.sciencedirect.com/topics/pharmacology-toxicology-and-pharmaceutical-science/sun-protective-clothing

Harvard Health Publishing on the best sun-protective clothing - https://www.health.harvard.edu/staying-healthy/the-best-sun-protective-clothing

American Council on Science and Health on sun protection - https://www.acsh.org/news/2024/03/11/should-we-fear-sun-or-sun-protection-17707

Skin Cancer Foundation on sun-protective clothing - https://www.skincancer.org/skin-cancer-prevention/sun-protection/sun-protective-clothing/
Cleveland Clinic on whether sun-protective clothing actually works - https://health.clevelandclinic.org/does-sun-protection-clothing-actually-work
U.S. National Library of Medicine on an overview of ultraviolet protective clothing - https://pmc.ncbi.nlm.nih.gov/articles/PMC9414157/

University of Utah Health on what clothing is best for sun protection - https://healthcare.utah.edu/huntsmancancerinstitute/news/2023/08/what-clothing-best-sun-protection

University of Texas MD Anderson Cancer Center on 7 things to know about UPF - https://www.mdanderson.org/cancerwise/7-things-to-know-about-upf--sun-protection-and-clothing.h00-159698334.html

ARPANSA, Australian Radiation Protection and Nuclear Safety Agency on UV rating tags - https://www.arpansa.gov.au/our-services/testing-and-calibration/ultraviolet-radiation-testing/labelling-sun-protective-clothing

Note - Our blog is researched and written by one of us at The Pharmacy, not AI or an external service. Let us know your thoughts on these topics and/or what you'd like to see here!

Mosquito bites

Sat, 28 Jun 2025 15:30:30 GMT

June 2025

Why do mosquitos bite us?

We might surmise many reasons, but actually it's simply because female mosquitos need the protein in blood to develop eggs. A mosquito can drink up to 3 times its weight in blood, or 0.000264 ounces, or 0.0075 grams (a mosquito weighs about 0.000088 ounces / 0.0025 grams).

Both female and male mosquitos eat flower nectar, and male mosquitos don't bite. Females can live about 6 to 8 weeks, and they can lay eggs about every 3 days during that time.

To note, some types of mosquitos feed only on snakes, frogs, or other cold-blooded animals, and other mosquitos prefer birds. Still others prefer cows, horses, and people. There are more than 3,500 species of mosquitos in the world, and about 175 of them are found in the U.S.

Female mosquitoes have receptors on their antennae that detect the carbon dioxide that we exhale and they follow the plumes of CO ₂ in the air to locate their next meal. They are attracted to octenol (a chemical released in our sweat) as well as cholesterol, folic acid, certain bacteria, skin lotions, and perfume. They use the heat sensors around their mouthparts to detect the warmth in our bodies and to locate our capillaries.

A female mosquito "bites" with a long, pointed mouthpart, called a proboscis, which is serrated. It pierces our skin, locates a capillary (small blood vessel), and draws blood through one of two tubes. A mosquito may bite 20 times before it finds a capillary! The other tube serves to pump its saliva into our skin. That saliva contains a mild painkiller (to numb the bite area) and an anti-coagulant (prevents blood from clotting).

How does our skin react?

Most people are allergic to mosquito saliva, which causes the area around the bite to swell and itch. This is caused by histamine in our bodies which dilates our blood vessels to allow white blood cells, blood plasma proteins, and other immune system elements, to access the site of the bite. The skin of some people develops blisters instead of hard bumps, and others get dark spots that look like bruises.

Don't scratch bites! Much as it is hard to do, especially for kids, it is best not to scratch bites because they can become infected. An infected bite can be red, feel warm, or a red streak may spread outward from the bite. If symptoms worsen, please seek medical attention.

Scratching might give temporary relief, but it doesn't solve the underlying itchiness problem. We discuss some options further below.

What can we do about it?

Given that mosquito-borne diseases are undesirable and being bitten by a mosquito can be highly uncomfortable, the best actions are those that help to prevent being bitten in the first place.

Most female mosquitoes lay their eggs in standing water (in as little as an inch), so a logical thing to do is to ensure that there is no standing water nearby, for example, in pails or any containers outside. In warm weather, most mosquito eggs hatch within three days.

To note, some mosquito species don't need water to hatch, so another smart thing to do is to have a multi-pronged approach to avoid mosquito bites.

There are many mosquito-repelling products on the market and if you have any questions about ingredients, please feel free to ask one of our pharmacists. To note, if you're spending time outside in the sun and need a mosquito repellant as well, it is recommended to put on sunscreen first (yes, even mineral ones that stay on top of the skin to reflect UV rays), then repellant.

Another method to avoid being bitten is to wear loose, long-sleeved clothing (long pants too). Some researchers have observed that zebra patterns may protect from biting flies, but more studies are needed and they have not studied the effect of zebra patterns on mosquitos.

There is also clothing treated with permethrin available, or you can treat your items or gear yourself with permethrin.

Finally in terms of avoidance, hanging around dragonflies or near bodies of water that have mosquitofish might be helpful as those are two main predators of mosquitoes. In fact, some towns in Maine release dragonflies every summer to help control mosquito populations.

If there is the possibility of being exposed to mosquitoes at night, using a mosquito net above your bed helps, but do be careful not to have your skin touching the net as that could be counter-productive. Also, during the day, collapse the net so that mosquitoes can't find their way inside. Some mosquito nets are treated with insecticide as well.

After being bitten, using an antihistamine or a corticosteroid can each help with the itching. Please feel free to ask our pharmacists about your options (pill, cream, ointment, patch). An alternative to medication is applying ice to the bite for about 10 minutes. That can slow the amount of blood flowing to the area and reduce inflammation, pain, swelling, and itchiness.

Chamomile tea (contains terpenoids and flavonoids that have antihistamine properties), honey (contains catalase, an enzyme that helps with minor inflammation), and oatmeal (contains gluten to help with itchiness) are other ideas suggested by the Cleveland Clinic (see the last link in the References and Resources list below).

We hope your summer is mosquito-bite-free!

Note: One of us at the pharmacy is a mosquito magnet and she has experimented with not touching or scratching bites -- yes, through the extremely itchy phases, right after the bite and in the evening -- and found that it prevents the bite from staying itchy the following days. We'd love to hear your experience since this only a sample size of one!

References and Resources

Children's Hospital Colorado on mosquito bites: https://www.childrenscolorado.org/conditions-and-advice/conditions-and-symptoms/symptoms/mosquito-bite/

CDC tips on avoiding mosquito bites: https://www.cdc.gov/mosquitoes/prevention/index.html
Cumberland County, New Jersey on 29 mosquito facts: https://www.cumberlandcountynj.gov/mosquito-29

National Health Service UK on mosquitoes and travelling: https://www.fitfortravel.nhs.uk/advice/malaria/mosquito-bite-avoidance

National Geographic on mosquitoes: https://kids.nationalgeographic.com/animals/invertebrates/facts/mosquito

Entomology Today on mosquito-borne disease transmission cycles: https://entomologytoday.org/2016/07/08/who-what-and-where-do-mosquitoes-bite/

Nature, Scientific Reports, on Zebras repel biting flies: https://www.nature.com/articles/s41598-022-22333 -7

Canadian Broadcasting Corporation on how mosquitoes don't just lay eggs in standing water: https://www.cbc.ca/news/science/mosquito-eggs-water-1.4069272

CNN on making like a zebra: https://www.cnn.com/2019/01/17/health/zebra-stripes-insect-bites-scli-intl

UC Davis on zebra research: https://www.ucdavis.edu/curiosity/news/how-zebra-stripes-disrupt-flies-flight-patterns

CDC on mosquito bites and mosquito-borne viruses: https://www.cdc.gov/mosquitoes/about/about-mosquito-bites.html

Cleveland Clinic on mosquito bites: https://my.clevelandclinic.org/health/diseases/17695-mosquito-bites

Note - Our blog is researched and written by one of us at The Pharmacy, not AI or an external service. Let us know your thoughts on these topics and/or what you'd like to see here!

It's time to talk about ticks

Fri, 30 May 2025 12:02:18 GMT

May 2025

Unfortunately, five of the eight tick species in the U.S. known to bite humans and cause disease live in Arkansas. And since the diseases range from Rocky Mountain spotted fever, to West Nile Virus, to Tularemia (aka rabbit fever), it is wise to take steps to prevent being bitten by a tick. The adage that an ounce of prevention is better than a pound of cure is especially true here since some of those diseases can be difficult to diagnose and treat.

It is comforting to keep in mind, however, that not every tick is infected, so being bitten by a tick doesn't necessarily mean getting sick.

Where to watch out for ticks

Ticks live in grassy, brushy, or wooded areas, so when outdoors, try to avoid such areas (even in urban parks) or stay in the center of trails. Be aware that outdoor activities such as walking the dog, camping, gardening, or hunting can mean exposure to ticks.

Ticks don't have eyes, so they use other sensory receptors to find hosts. They pick up our CO ₂ . They don't fly, but they can latch on to birds and thus can travel far.

Ticks can also live on animals such as pets. Keep your pets clean and try to prevent them from going into brushy, wooded areas where possible.

Ticks are most active during mid-day and they move more quickly in humid environments, which is unfortunate for us here in Arkansas. When outside, check for ticks regularly and if one is found, remove it promptly.

Notes on clothing

Light colored clothing makes it easier to spot ticks. Long sleeves and long pants tucked into socks or boots can help prevent ticks from getting onto your skin.

Some people like to treat their clothing with permethrin as an additional preventive measure. Pre-treated clothing is also available. However, if you have a pet cat, it is good to keep in mind that permethrin is highly toxic to cats. Discuss any questions about this with your cat's veterinarian.

Check clothing for ticks and once inside again, put your clothes in a tumble dryer on high heat for an hour, then wash the clothing as normal. If the clothes require washing first, use hot water because cold and warm water will not kill ticks.

What kind of insect repellant is best

The CDC recommends using an insect repellant that is registered with the U.S. Environmental Protection Agency (EPA). The EPA has several helpful websites on this topic:

General information about insect repellents, using them, and about preventing insect bites - https://www.epa.gov/insect-repellents

Search the EPA database for a repellant for your situation, based on their questionnaire - https://www.epa.gov/insect-repellents/find-repellent-right-you

Insect Repellent Bot that guides you through Q&A about insect repellents (scroll down to the "Get Started" button on this link) - https://www.cdc.gov/ticks/prevention/index.html

After being outdoors

Shower or bathe as soon as possible and within at least two hours of coming indoors -- it has been shown to reduce the risk of getting Lyme disease and can help wash off unattached ticks. It's also a good opportunity to do a full body check for ticks. Comb through your hair. Check your child's body for ticks, especially crevasses and darker areas:

under the arms
in and around the ears
inside the belly button
back of the knees
in and around the hair
between the legs
around the waste

Examine gear and pets.

To remove ticks that have latched on, position tweezers as close to the skin as possible and lift up on the tick firmly without twisting or jerking. You can also use a tick remover. Don't try to soak a tick with something in an attempt to force it to remove itself because doing so can cause the tick to suffocate and regurgitate bacteria-laden saliva that can increase the risk of disease.

After removing a tick, wash the area with hot, soapy water and with rubbing alcohol. For the next few days and weeks, watch for signs of fever, headache, nausea and rash, especially around the bite. See a doctor as soon as you notice symptoms because early diagnosis and treatment is always best.

You can put the tick in a Ziploc-style bag with a piece of damp paper towel or moist cotton ball. Close the bag and seal the closed opening with tape. You can do this for either your doctor and/or to send to the Arkansas Tick-borne Pathogen Surveillance Program, a collaborative study being conducted by UAMS College of Medicine, Department of Microbiology and Immunology, UA-Fayetteville, and the Arkansas Department of Health. For more information, here is the web page about the study:

https://medicine.uams.edu/mbim/resources/arkansas-tick-borne-pathogen-surveillance-program/

References and Resources (in addition to the links above)

US Centers for Disease Control and Prevention (CDC) on where ticks live in the US - https://www.cdc.gov/ticks/about/where-ticks-live.html?CDC_AAref_Val=https://www.cdc.gov/ticks/geographic_distribution.html

Arkansas Department of Health on tickborne diseases - https://healthy.arkansas.gov/programs-services/diseases-conditions/diseases-from-animals-insects/tickborne-disease/

First Security Bank on identifying ticks in Arkansas - https://onlyinark.com/homegrown/identifying-ticks-in-arkansas/

McGill University on ticks - https://mcgillnews.mcgill.ca/tick-talk-understanding-and-preventing-tick-borne-illnesses/

Arkansas Game and Fish Commission on taking precautions - https://www.agfc.com/news/adh-urges-arkansans-to-take-precautions-during-tick-and-mosquito-season/

National Library of Medicine on a clinical review of tick-borne disease in Arkansas - https://pubmed.ncbi.nlm.nih.gov/27263175/

Note - The Pharmacy at Wellington's blog is written by a human

Soft as Baby Skin

Sat, 26 Apr 2025 02:35:14 GMT

April 2025

We know that "soft as baby skin" refers to something that's exceptionally soft and smooth, but why baby skin?

It turns out that baby skin is in fact quite different from children and adult skin, and yes, it is very soft and smooth.

In the womb and during the first few hours of life, babies are covered with a creamy white substance (called vernix caseosa) which provides a protective coating. For the fetus, vernix helps to protect the skin from electrolytes and other substances in the womb. After birth, vernix keeps skin from drying out, maintains body temperature, and promotes immunity. In the hours and days after birth, vernix slowly wears off with touch and bathing.

The skin has the same functions throughout life:

it acts as a barrier
it provides protection from the sun
it helps to maintain body temperature (thermoregulation)
it provides protection from harmful substances in the environment (immune surveillance)
it is involved in hormone production
it prevents excessive fluid loss
it allows for touch / feel (sensory perception)

Please note that in this blog we are not discussing premature babies as they may have other skin issues and conditions.

Skin continues to develop throughout the first years of life, and it is more vulnerable during this time, so it makes sense to treat baby, infant, and young children's skin carefully:

Topical solutions - Use products recommended by your child's dermatologist rather than relying on a product label "recommended by dermatologists", which may refer to recommendations for adults. Our pharmacists are happy to help with identifying ingredients and what is safe to use for your baby or child. For example, topical iodine solutions are not to be used on neonates. Neonate skin has high permeability to topical agents (meaning that the skin allows them to get through). This permeability decreases with age.

Adhesive tapes - Removing them can increase local permeability, making the skin more fragile. It would be prudent to avoid using adhesive tape on infant skin where possible.

Medicated skin products - Only essential products should be applied to a baby's skin, under the direction of the baby's pediatrician. Besides the reasons noted above, babies have a high surface area to volume ratio. That is, there is a lot more skin in relation to body size, as compared to an adult. This means that there is more surface area to absorb medication but less volume within the body where the medication can take effect. Thus, the importance of closely following the baby's pediatrician's instructions for where and how often to apply medicated skin products.

Too hot or too cold - The subcutaneous fat in newborn skin has a different composition than that of adults and is sensitive to cold temperatures. For example, after exposure to cold, a baby's skin (on cheeks) may turn reddish or purplish. It is best to avoid too cold or too warm temperatures.

Full-term babies do sweat, because of heat (thermal sweating), or emotional sweating, caused by emotions such as fear, pain, and anxiety. Thermal sweating initially involves the forehead and emotional sweating involves mainly the palms and soles.

Bathing - Daily bathing isn't necessary for babies and simply getting wet or soaking 10 minutes or less should be enough. Using a washcloth during the first four weeks of life isn't recommended as it can make neonatal skin more fragile.

Photoprotection - Melanin in our skin protects us from UV light damage, and infants have a lower concentration of melanin as compared to adults. Because baby skin is sensitive and there is a high surface area to volume ratio, it is better to use sun-protective clothing and avoid sun exposure than to put a sunblock on a baby's skin before going outside. To note, researchers have found that frequent sunburns and exposure to sunlight in childhood are strongly related to skin cancer (melanoma) development, so early protection from the sun is recommended.

Since babies can have other skin problems including baby acne, cradle cap (a type of dermatitis), etc., it is best to consult with a pediatric dermatologist, to preserve the integrity of your baby or child's skin to avoid future complications.

Knowledge and acting based on that knowledge is power!

References and Resources

Medscape on how infant skin differs from adult skin - https://www.medscape.org/viewarticle/743529

Healthline on baby skin - https://www.healthline.com/health/must-know-facts-about-your-babys-skin#tak eaway

National Library of Medicine on skin physiology of the neonate and infant - https://pmc.ncbi.nlm.nih.gov/articles/PMC4593874/

Motherly on baby skin care questions - https://www.mother.ly/baby/baby-health/pediatric-dermatologist-on-baby-skin/

Note - The Pharmacy at Wellington's blog is written by a human

Our own Liz E. is a certified CHW!

Thu, 27 Mar 2025 07:37:44 GMT

March 2025

Congratulations Liz Elsen on being certified to be a Community Health Worker (CHW), in addition to being an awesome Pharmacy Technician!

What does that mean? What does a CHW do?

The role of a CHW can vary greatly depending on the company you work for. However, all CHWs are responsible for advocating for the members of their community.

We help connect people with resources to meet their needs. This could be anything from help with food or housing insecurities, meeting healthcare needs, finding information and support for caregivers, and organizing events that bring members of the community together. There is no charge to the people who receive this service.

The addition of this certification to a licensed pharmacy technician is relatively new. For some technicians, some of these duties fit right in with what they already do for community engagement with their pharmacies, such as vaccine outreach. So, we are excited to see how we can expand this CHW role at The Pharmacy at Wellington.

For those of you who are interested, here is the website of the Arkansas Community Health Worker Association (ARCHWA):

https://www.archwa.org/

Why did you decide to become a CHW?

We learned about the opportunity through CPESN (Community Pharmacy Enhanced Services Network), and I thought it sounded like a great way to expand upon my role as a technician for the pharmacy. Brittany (our founder and co-owner) asked if I was interested, and I said yes!

Note: our pharmacist Megan Smith is Academic Facilitator for CPESN Arkansas

What sets you apart from other CHW's? For example, in your experience, your approach, etc.?

I am part of one of the first groups of pharmacy technicians in Arkansas to have completed this licensing program through ARCHWA! I also have a unique role since I also work at Harmony Health Clinic, where I am able to use my connections to aid some of our patients with more resources.

Harmony Health Clinic is a non-profit, 501(c)(3), free medical and dental clinic in Little Rock for the uninsured and underserved.

Those of you who are familiar with us at The Pharmacy at Wellington will know that we have been volunteering at their pharmacy counter and on their Board over the years. fyi, here is a link to their website, and they have a super fun fundraising evening coming up (Saturday, May 3rd):

https://www.harmonyclinicar.org/bollywood-nights

Who do you serve as CHW? Can anyone use your services? How does one get in touch with you? Are appointments required?

Anyone needing help with finding health and/or community resources can just reach out to us at The Pharmacy at Wellington. They can ask for me on the phone (501-708-4320), and if needed, I'll arrange an appointment for them to come have a meeting in person.

There are no low-income requirements to talk with me about resources and be referred. We just provide the service based on need.

It's one way for us to give back to our community and help to improve the lives of those around us. If you know of anyone needing assistance, please feel free to refer them to us. And if you know of any new resources in the community, please also feel free to let me know!

References and Resources

CPESN (Community Pharmacy Enhanced Services Network) Arkansas website - https://cpesn.com/networks/arkansas

Note - The Pharmacy at Wellington's blog is written by a human

Syphilis is making a comeback, including in Arkansas

Thu, 20 Feb 2025 20:58:35 GMT

February 2025

Source: https://www.cdc.gov/sti-statistics/annual/slides.html

Let's get past the stigma and learn about it, to beat it!

What is it exactly and is there a treatment for it?

The short answer is that it's a sexually-transmitted disease that runs the gamut of sexual situations (genital, oral, anal, heterosexual, LGBTQ+, paid sex, consensual sex, rich, poor, 15 to 72 years old, etc.). It can also be transmitted from mother to fetus, during breastfeeding, and in very rare cases, through blood transfusion or an organ transplant.

And yes, there is treatment for it -- more info below.

Left untreated, syphilis, caused by a bacterium called Treponema pallidum , can result in serious heart and brain damage, blindness, deafness, and paralysis. A person who suspects having been exposed to it or thinks they might have some symptoms should talk with their doctor about getting tested immediately.

Symptoms to look for -- the different stages of syphilis and how they can affect a person

One reason why syphilis goes undetected is that its early symptoms mimic other infections or are easy to miss. The disease has four stages.

Primary - within three weeks of being infected

A lesion or canker (usually just one, but sometimes more than one) up to a few centimeters can appear at the spot of infection, for example, at the genital organs, oral region, or anorectal region. It isn't generally painful at this stage, but it can be associated with ganglions that can be a little sensitive. It is of course more difficult to detect lesions inside the vagina or anus than on the penis or in the mouth. The immune system usually clears the symptoms within 3 to 6 weeks, but it doesn't cure the disease because the bacteria is still in the body and escalates to secondary syphilis.

Secondary syphilis - 2 to 12 weeks after infection

A rash (blisters or red dots) can appear while the first chancre heals or a few weeks after it heals. It doesn't itch, but it can leave white scabs which dry and become flakey. The rash usually starts on the trunk of the body (chest, stomach, pelvis, back) and is also common on the palms of the hands and the soles of the feet, but they can appear everywhere on the body. They may be very faint and hard to see. An infected person can also experience at the same time: runny nose, congestion, sore throat, fever, blisters on the skin or in the mouth that look like warts, inflammation or infection of the liver, hepatitis, and/or pain in the bones. Without treatment, symptoms from this stage can come and go for months or years.

Source: https://www.cdc.gov/syphilis/hcp/images/index.html

 Latent or dormant stage

During the latent stage, the bacteria is in between the cells and reproduces without being detected by the immune system, so there are no symptoms. However, the person continues to be contagious during the whole first year after infection, so the disease can be passed on to someone else without knowing it. Also, left untreated, syphilis can move on to the next stage.

3rd or tertiary stage, late syphilis

This very serious stage affects about 30% to 40% of people with untreated syphilis. At this point, the disease can give a whole variety of symptoms, including neurological and cardiovascular issues: meningitis, cranial nerve issues, fascia paralysis, anomalies in the movement of the eyes, vision and hearing problems, cognitive issues, dementia, emotional issues, paranoia, balance, continence issues, aorta proximal aneurisms, inflammation of the heart, inflammatory masses all over the body.

At any stage of the disease, syphilis can affect the brain, spinal cord, eyes, and other body parts.

About 10% of people who have syphilis and don't get treatment die from the disease. It is currently not possible to know who will fall into which category.

Image credit: Daniel Reche on Pexels

Congenital syphilis -- transmission from mother to baby

Syphilis can be transmitted from mother to fetus at any of the four stages of the disease.

Infection during pregnancy can lead to miscarriage, stillbirth, neonatal death shortly after delivery, or lifelong medical issues.

For example, if a child who has unknowingly contracted congenital syphilis survives, s/he may have bones so brittle that they break when the child begins to grow and put on weight. At present, nothing can be done to alleviate or reverse that symptom when the disease has reached that stage without treatment.

If a woman is considering getting pregnant, it is smart for her to bring up the topic of testing for syphilis with her gynecologist. The American College of Obstetricians and Gynecologists (ACOG) recommends testing pregnant women at the first prenatal care visit, during the third trimester, and at birth.

How is syphilis treated?

It is treated with penicillin and other antibiotics. As we can see from the potentially devastating effects of the disease as it progresses, getting treated as early as possible is key. Please note that a person may still be contagious for a short time after treatment, so adhering to medical advice about taking precautions to limit its spread is smart.

Together, let's limit the spread!

The evolution of syphilis parallels the discovery of penicillin (in 1940). Infections diminished after the discovery through to the 1980's, when HIV was essentially a death sentence and there was a lot of education about safe sex (i.e. using condoms), which also reduced the number of syphilis cases. The lowest rate of syphilis in the U.S. was achieved in 1999.

However, there has been an increase in infections since 2000. Today, cases in women are rising more quickly than cases in men.

Let's help spread the word -- armed with knowledge, we have the power to limit and even reduce the spread of syphilis.

References and Resources

Johns Hopkins Bloomberg School of Public Health on the syphilis spike - https://publichealth.jhu.edu/2024/why-is-syphilis-spiking-in-the-us

BBC on syphilis in the world - https://www.bbc.com/future/article/20230706-the-troubling-rise-in-congenital-syphilis

Radio Canada on the return of syphilis - https://ici.radio-canada.ca/ohdio/premiere/emissions/penelope/episodes/786660/rattrapage-mardi-30-janvier-2024

National Library of Medicine on alternative treatments for syphilis during pregnancy - https://pmc.ncbi.nlm.nih.gov/articles/PMC6750027/

ACOG testing recommendations for pregnant women - https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2024/04/screening-for-syphilis-in-pregnancy

CDC (U.S. Centers for Disease Control) - slides from surveillance of sexually transmitted diseases - https://www.cdc.gov/sti-statistics/annual/slides.html

Mayo Clinic on syphilis - https://www.mayoclinic.org/diseases-conditions/syphilis/symptoms-causes/syc-20351756

Note - The Pharmacy at Wellington's blog is written by a human :)

How's your liver doing?

Tue, 21 Jan 2025 00:07:08 GMT

January 2025

Drawing credit: Rachmat on Vecteezy

In light of Dry January, when many people choose to go a month without alcohol or reduce their alcohol consumption, it's encouraging to know that doing so is good for your liver. Since some liver problems don't have symptoms and you can't survive more than a day or two without your liver, it's smart to do what you can to take care of the one liver you're born with.

Let's start with the basics and move on to what scientists know about how your liver regenerates itself.

What does your liver do?

Your football-sized organ sits above your stomach and:

It filters blood from the gastrointestinal system before it is delivered to your heart. This means removing toxins, including those that are toxic to your brain, and converting them into waste products. When this filtering is reduced or stops, toxic substances can circulate in the blood and reach the brain.
Your liver produces proteins that help to balance the thickness of your blood.
It creates bile which is used in food digestion and which helps the body to absorb nutrients and medications.

Your liver works hand-in-hand with your other organs, such as the intestines, heart, and brain. Thus, a liver that is in trouble affects how your other organs work.

Image credit: Clker-free-vector-images on Pixabay

What are various liver diseases?

Fatty liver - This is where fat builds up in the liver, causing swelling and damage. It can be caused by too much alcohol or there is a version called non-alcoholic fatty liver disease, where fat build-up occurs with little or no alcohol. For example, diabetes can cause and/or aggravate non-alcoholic fatty liver disease.

Fatty liver often has no symptoms, although warning signs can include a swollen abdomen, nausea, itching, or a yellow tint to the skin and the whites of the eyes. It is often first detected by blood tests for liver function, but blood tests can't tell how severe the condition is. To determine severity, an ultrasound and/or liver biopsy is performed.

Cirrhosis - Fatty liver can lead to cirrhosis, which is when liver cells are replaced with scar tissue, preventing the liver from functioning normally.

Liver cancer - refers to cancer that starts in the liver. In early stages of liver cancer, many people don't have symptoms, but when symptoms do appear, they can include: losing weight without trying, loss of appetite, upper abdominal pain, nausea, vomiting, general weakness/fatigue, abdominal swelling, jaundice, and white/chalky stools.

Liver failure - a liver that stops functioning can cause coma.

To note, liver dysfunction can cause a condition called hepatic encephalopathy , which is brain dysfunction. This condition can result in a wide variety of symptoms that can be mild or sever and that can occur suddenly or come on gradually and affect a person's:

mood and personality
behavior and impulse control
memory, concentration, and thinking
consciousness, lucidity, and sleep patterns
coordination and motor functions
autonomy and ability to care for oneself

Original drawing credit: Rachmat on Vecteezy

What can affect the health of your liver?

Genetics - some liver problems are inherited.

Viruses - certain types of hepatitis cause liver problems.

Medical conditions:

High cholesterol - can increase the risk of getting fatty liver.
High blood pressure - can also raise the risk of getting fatty liver.
A person who has fatty liver and type 2 diabetes can see their fatty liver get worse if they don't manage their diabetes.

Some medications:

For example, taking more acetaminophen (paracetamol, Tylenol) than the recommended dose can cause damage, to the point of liver failure. Acetaminophen, the main active ingredient in Tylenol, is also commonly found in over-the-counter drugs such as Dayquil and Nyquil, Actifed, Alka-Seltzer, Sudafed, Robitussin, Dristan, Theraflu, etc., including corresponding store brands. Certain prescription medications also contain acetaminophen.

The recommended maximum dose for adults is 650 mg to 1000 mg every 4 to 6 hours, not to exceed a total of 4 grams per day. For children, maximums can vary depending on age and weight. Taking too much acetaminophen can happen, especially where several medications are taken at the same time. Be sure that you and your loved ones have consulted with a doctor or pharmacist before taking over-the-counter and/or prescription medications.

Another example of medications that can cause liver problems is heartburn medication (containing Proton Pump Inhibitors, or PPI). Again, please discuss with your doctor or pharmacist before taking such medication.

Lifestyle :

Alcohol - Mixing alcohol with drugs containing acetaminophen can be very dangerous. Alcohol on its own can begin to scar your liver, at a dose of just 4 oz per day of hard liquor for men (2 oz for women). 4 oz is half a cup.

Excess weight - where extra fat is stored in the body, including in the liver.

Diet high in fructose - initial research points to how high fructose corn syrup can damage the intestinal barrier, allowing bacteria and toxins to leak into the bloodstream, causing immune cells to react and produce an inflammatory response. There is also an increase in the level of enzymes that convert fructose into fatty deposits in the liver. To note, fructose used in processed foods is often high fructose corn syrup (HFCS), to watch out for on ingredient labels.

How does your liver regenerate?

We might be familiar with how a lizard which has lost its tail can regrow it. The lizard's body uses stem cells to reproduce the same structure, resulting in a new tail.

Your liver doesn't regrow in the same way. Instead, it compensates loss of liver tissue (from liver damage, organ donation, or liver cancer surgery) by growing the existing liver cells bigger. These existing cells respond to a signal to grow until they receive a signal to stop. The resulting "new" liver is approximately the same size as before the growth, although it might not have exactly the same shape.

A great thing about this process is that the liver continues its regular functions of cleaning the blood, regulating cholesterol, etc., all the while compensating for tissue loss!

Researchers are currently working on understanding how the signals work. The mechanisms of both starting and stopping the compensating growth are of course quite important.

One thing that scientists and doctors do know is that cyclical liver damage can lead to cirrhosis. For example, if a person has too much alcohol and develops fatty liver, stops drinking for a while to let the liver repair itself, resumes drinking, causing liver damage, stops drinking so the liver regenerates, and so on, this cycle causes scar tissue, which means cirrhosis.

So the liver can repair itself, but to a limit.

What can you do to take care of your liver?

From the information above, it is clear that reducing body fat by eating a balanced diet and exercising regularly, limiting alcohol, and paying attention to the medications and supplements you take are key. We would also suggest talking with your doctor or one of our pharmacists about your risk of hepatitis, as well as your risk for liver disease, especially if a family member has had it.

We would like to note that liver cleanses are not recommended as they have not been proven to rid the body of damage from excess consumption of food or alcohol. They have also not been proven to correct existing liver damage.

Why is taking care of your liver so important?

You only have one.
Its ability to regenerate itself is limited.
It can affect the way your other organs work.

References and resources

Liver Foundation on common medicines with acetaminophen - https://liverfoundation.org/wp-content/uploads/2022/06/Common-Medicines-with-Acetaminophen-Know-Your-Dose.pdf

National Institute of Health (NIH) National Library of Medicine, National Center for Biotechnology Information (NCBI) on acetaminophen toxicity - https://www.ncbi.nlm.nih.gov/books/NBK441917 /

NIH News in Health on how your liver delivers - https://newsinhealth.nih.gov/2014/03/your-liver-delivers

Mayo Clinic on how to protect your liver - https://www.mayoclinic.org/diseases-conditions/diabetes/expert-answers/diabetes/faq-20058461

Johns Hopkins Medicine on detoxing your liver, fact versus fiction - https://www.hopkinsmedicine.org/health/wellness-and-prevention/detoxing-your-liver-fact-versus-fiction

Mayo Clinic on liver cancer - https://www.mayoclinic.org/diseases-conditions/liver-cancer/symptoms-causes/syc-20353659

American Liver Foundation on avoiding liver disease - https://liverfoundation.org/resource-center/blog/healthy-liver-tips/

Radio Canada on how the liver regenerates itself - https://ici.radio-canada.ca/ohdio/premiere/emissions/moteur-de-recherche/episodes/946924/rattrapage-du-8-oct-2024-les-superpouvoirs-du-foie-et-le-carbone-capte-par-les-vieilles-forets

Johns Hopkins Medicine on 5 ways to be kind to your liver - https://www.hopkinsmedicine.org/health/wellness-and-prevention/5-ways-to-be-kind-to-your-liver

NCBI's list of selected medications and supplements and their toxicity to the liver - https://www.ncbi.nlm.nih.gov/books/NBK547852/#IX-A

Cleveland Clinic on ammonia levels in the blood (it is toxic to the brain) - https://my.clevelandclinic.org/health/articles/22686-ammonia-levels

Cleveland Clinic on hepatic encephalopathy - https://my.clevelandclinic.org/health/diseases/21220-hepatic-encephalopathy

NIH on fungi in the gut linked to alcoholic liver disease - https://www.nih.gov/news-events/nih-research-matters/fungi-gut-linked-alcoholic-liver-disease

MD Anderson Cancer Center on how the liver's ability to recover plays into liver cancer surgery - https://www.mdanderson.org/cancerwise/liver-regeneration--how-the-liver-s-ability-to-recover-plays-into-liver-cancer-surgery.h00-159623379.html

BioTechniques on why sometimes a liver doesn't always renew itself - https://www.biotechniques.com/molecular-biology/how-does-the-liver-regenerate/

NIH on how high fructose intake may trigger fatty liver disease - https://www.nih.gov/news-events/nih-research-matters/how-high-fructose-intake-may-trigger-fatty-liver-disease

NIH on how blocking stomach acid may promote chronic liver disease - https://www.nih.gov/news-events/nih-research-matters/blocking-stomach-acid-may-promote-chronic-liver-disease

Note - The Pharmacy at Wellington's blog is written by a human :)

Winter skin care

Sun, 29 Dec 2024 18:34:28 GMT

December 2024

Photo credit: Linda Prebreza on Pexels

Now that winter solstice is behind us and it's officially winter, we thought that a refresher about taking care of our skin might be useful. We have tried to keep our suggestions below easy, all the while being effective.

The suggestions below are general ones to help prevent dry, itchy, cracked skin in winter. A spring/summer skin routine would likely be different, with lighter moisturizers (for example, with lotions rather than creams or ointments), etc. If you have specific questions or conditions, please be sure to consult with your doctor, dermatologist, or stop by to see one of our pharmacists. Our pharmacists can also help to interpret ingredients lists of products or advise whether your medications could affect your skin.

Please note that a person's medical history, conditions, medications, age, and lifestyle greatly affect what is recommended for their specific situation. Keep in mind that what might work for one person might not be best for another person.

Why is dry skin not desirable?

Apart from being the first line of defence against bacteria, infections, etc., our skin is our largest organ and to do its job well, it needs to be properly hydrated. Dry skin can pull, get rough, red, inflamed, chapped, itchy, and/or flaky and/or produce pus. It can crack and lead to infections or eczema (which is a group of skin conditions that causes red, dry, bumpy, and itchy patches of skin).

A simple at-home test to see if your skin is dry is to lightly run the back of your fingernail along the area you're testing, without scratching your skin. If your skin flakes -- you see "snowflakes" or dust, or if there's a light line mark where you ran your fingernail, it's time to re-hydrate your skin.

Tips for maintaining hydrated skin in winter

These suggestions are not presented in any order. The more that you can implement, the better for your skin!

Take shorter showers or baths (10 minute maximum) and use warm wather rather than hot water. Water, especially hot, soapy water, removes the skin's natural oils and causes dryness.
Use soap minimally and opt for gentle or moisturizing soaps without deodorants, perfumes, or alcohol products as they can also remove the skin's natural oils.
Apply a moisturizer all over, immediately after bathing or immediately after washing your hands, to seal in the moisture. This includes a moisturizer for the face and a moisturizer for all over the rest of your body. More on the difference below.
Choose face and skin moisturizers and lip balm that are free of perfumes, fragrances, or other products (natural or chemically produced) that can cause irritation or an allergic reaction. More on moisturizers below.
Shave after bathing when the skin is moist and use shaving cream, lotion, or gel. Use a sharp razor and shave in the direction the hair grows, rinsing the razor after each stroke of the blade.
Use fragrance-free laundry detergents and avoid fabric softeners, for the obvious reason that clothing is in constant contact with our skin.
Avoid tanning beds and artifiical sunlamps as they can damage skin and increase the risk of skin cancer. If you use self-tanners, use extra moisturizer as they tend to dry out the skin.
Outside, protect your hands from the cold by wearing gloves. Protect your exposed skin by applying a broad-spectrum sunscreen with SPF of at least 30 because winter UV exposure can still lead to premature aging of the skin and skin cancer. As well, even on cloudy days, up to 80% of the sun's harmful UV rays can penetrate your skin.
A balanced diet and drinking enough water throughout the day can also make a difference. More on this below.

Photo credit: Carolina Grabowska on Pexels

More information

Dry skin - different parts of the body

Applying moisturizer to these areas where the skin is often dry can help: hands, feet, face, elbows, around your mouth, genitals, legs.

To note, the skin on our lips is thinner than elsewhere and is vulnerable to drying out, especially if we lick our lips, as that strips away natural oils. It is recommended to apply nourishing lip balm with ingredients such as shea butter, cocoa butter, beeswax, or coconut oil. An easy, inexpensive option is to simply apply pure petroleum jelly.

Our facial skin is thinner and more sensitive than our other skin, so face moisturizers are designed to be a bit thinner and less likely to cause acne. Generally, in winter, creams, oils, or balms are used on the face, while ointments and creams are used on the body. However, pay attention to your own skin to see what works best for you -- how heavy or light the moisturizers should be for you.

Ointments are great for hands and feet -- more on ointments vs other forms of moisturizers below.

Skincare products - cleansers and moisturizers

Reading the ingredients list of some products can be complicated, but here are some general guidelines:

Ingredients that are desirable (in alphabetical order):

Ceramides, coco butter, glycerin, hyaluronic acid, jojoba oil, lanolin, lauric acids, lecithin, linolenic, mineral oils, olive oil, petroleum jelly (or petrolatum), shea butter, silicone, sorbitol, squalane
These ingredients work in different ways, for example:
humectants - help to attract moisture to the skin
occlusives - help to seal moisture in the skin
emollients - smooth the skin by filling in the spaces between the cells

Ingredients that are to be avoided:

Benzyl alcohol, fragrances, glycolic acid, isopropyl alcohol, retinoids, retinols, salicylic acid, sulfates

Other notes:

Some lactic acid moisturizers can exfoliate dry, flaky skin while helping to maintain skin hydration -- check the ingredients list or ask one of our pharmacists.
Look for products that are suitable for sensitive skin.
Sometimes natural or chemically made molecules are added to remove fragrance. These can still cause allergic reactions, i.e. plant extracts, essential oils, etc.
SLS (sodium lauryl sulfate), commonly found in soaps, fabric softeners, personal care products, etc., can cause irritation, but you might not have sufficient exposure to it for it to be harmful. Alternative ingredients that serve as surfactants (cleaning agent that removes dirt) include: fatty alcohol ethoxylate, alkyl phenol ethoxylate, fatty acid alkoxylate, etc.
An inexpensive ointment moisturizer for the body is pure vegetable shortening. Simply apply small amounts and rub well.
In winter, limit the use of products containing anti-aging ingredients such as glycolic acid, salicylic acid, or retinol since they can contribute to drying out the skin.

Diet, hydration, and lifestyle

If you've been following our blog for a while, you'll already have an idea of these pointers:

Eat a balanced diet, with lots of fiber, fruits and vegetables, and lean proteins. Limit processed foods and sugary drinks.
Drink enough water (check out our blog about how to know you're getting enough water here : https://www.thepharmacyatwellington.com/back-to-basics-water )
Keep active
Get enough sleep and manage your stress

We'd like to specifically note that smoking or vaping can increase the formation of wrinkles. It makes the skin look older by narrowing the tiny blood vessels in the outermost layers of the skin, lessing blood flow and reducing the supply of oxygen and nutrients, resulting in more dull skin. Collagen and elastin, which give the skin its strength and suppleness, are damaged. There is also the increased risk of skin cancer on the lips (as well as other cancers).

Conclusion

It is possible to have healthy, hydrated skin throughout one's life ... it might mean making a few changes to one's routine or lifestyle, but it's definitely worth it!

References and resources

Cleveland Clinic on dry skin - https://my.clevelandclinic.org/health/diseases/16940-dry-skin
Mayo Clinic on 5 tips for healthy skin - https://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/skin-care/art-20048237
A dermatology clinic in the UK on winter skin care - https://www.stmichaelsclinic.co.uk/2024/01/08/winter-skin-care-tips-expert-advice-for-a-radiant-complexion/
American Academy of Dermatology on winter skin survival kit - https://www.aad.org/public/everyday-care/skin-care-basics/care/winter-skin-survival-kit
University of Cincinnati on winter skin care tips - https://www.uchealth.com/en/media-room/articles/winter-skin-care-tips-for-preventing-dry-cracking-skin
Columbia University Irving Medical Center on healthy winter skin - https://www.cuimc.columbia.edu/news/dermatologists-guide-healthy-winter-skin
Iowa Health Care on winter dry skin - https://uihc.org/health-topics/winter-dry-skin
Brown University on foods that are good for the skin in winter - https://www.brownhealth.org/be-well/top-winter-foods-your-skin
University of Queensland on SLS - https://medicine.uq.edu.au/article/2019/12/what-sodium-lauryl-sulfate-and-it-safe-use
Article by a water treatment company about surfactants - https://www.moleaer.com/blog/wastewater-treatment/understanding-surfactants-the-science-behind-soaps-and-detergents

Cleveland Clinic on squalane - https://health.clevelandclinic.org/squalan e
Harvard Health Publishing on 9 ways to banish dry skin - https://www.health.harvard.edu/staying-healthy/9-ways-to-banish-dry-skin

Different ways of taking medications

Thu, 17 Oct 2024 03:41:05 GMT

October 2024

When a person thinks about different ways of taking medications, what comes to mind would include: by mouth (orally), maybe by the skin (cream or a patch), or maybe solid vs liquid. When a pharmacist thinks of the options for medication administration, s/he thinks not only of what would work best for the medication's absorption, effectiveness, and availability, but also what would work best for the patient's age, lifestyle, and limitations.

This blog will cover some generic information, and if you have any questions about your or a loved one's medications, please don't hesitate to talk with one of our pharmacists, since each situation is unique.

Below are the main ways of taking medications and some thoughts about each.

Oral

One of the most common methods is to take a pill by mouth. Convenient, more or less easy or agreeable, it works well for people who have no issues with swallowing. Sometimes if a person (often a child) has trouble with a bad-tasting liquid medicine, a pharmacist can add a flavoring to mask the bad taste.

Some pills are coated with a time-release substance or have another mechanism so that the active ingredient is released over time, so pills that are intended to be swallowed whole should not be crushed.

Sometimes tablets or liquid medications are placed under the tongue rather than swallowed. There is an abundant network of capillaries and lymphatics* under our tongue, which results in faster medication action.

Taking medications under the tongue also avoids the stomach and liver, a path which diminishes drug concentrations. Concentration levels of pills made to be swallowed take this into account, so we should always follow instructions for how to take a medication.

Besides the speed of medication delivery under the tongue, another consideration is if a person might have excessive saliva, which could cause the medication to dissolve too quickly. Or if a person finds it hard to keep something under their tongue for a period of time without swallowing it, the sublingual method might not be best for them.

Some medications are administered in the mouth next to the cheek. This method results in slower absorption than under the tongue because buccal tissue is less permeable than sublingual tissue, but it still does avoid the stomach and liver path.

Inhalation and intranasal

Another area of the body that allows medications to enter the bloodstream quickly is in the respiratory tract. This method also bypasses the stomach and liver path.

Some medications are administered using a nebulizer, a machine that changes medication from a liquid to a mist so one can inhale it into the lungs. While there is a large surface area in the lungs and they are close to rich blood flow, medications administered using this path might not reach their destination because of obstacles along the way such as the aerodynamic filter of the lungs and the mucus lining the airways.

Other drugs are sprayed into the nose and get absorbed through the thin membrane that lines the nasal passage. To note, we administer FluMist, a nasal spray flu vaccine, and appointments can be made via the Vaccines page of our website.

This blog doesn't cover all the variables that can go into determining the best administration method, which can sometimes be very specific to individuals. For example, someone suffering from the common cold, or allergies, or a sinus infection, might not want to take their flu vaccine via a nose spray.

Rectal

This method is apparently more common in Europe than in North America, but it is useful especially for infants and the elderly, or in emergency situations where a person cannot swallow.

While not all drugs can be administered via the rectum, suppositories may prevent having some side effects caused by some swallowed drugs (ie gastric irritation, nausea, vomiting).

Intramuscular and subcutaneous

Vaccines are commonly administered via intramuscular injection, meaning vaccines are injected into a muscle. To note, this is not the same as a subcutaneous injection, which involves injecting into a layer of fat between the skin and the muscle. Insulin is a medication that needs to be injected subcutaneously.

A notable disadvantage of the intramuscular and subcutaneous methods is possible pain or discomfort at the injection site.

Transdermal

Drug delivery can also take place via patches on the skin. For example, some motion sickness medications are administered this way. Transdermal creams and gels are also made to penetrate the skin, resulting in active ingredients crossing the skin barrier and often having an effect on other areas of the body, not just on the part of the skin where the ingredients are applied.

Advantages of this method include that it is not invasive and that it by-passes the stomach and liver path. However, for reasons such as molecular size and structure, not many medications have been approved for transdermal administration.

To note, transdermal is not the same as topical. Topical applications rely instead on passive diffusion into the skin itself, creating just a local effect.

Conclusion

It can be understood from this cursory overview that many factors go into deciding the best way to administer a medication. Drug manufacturers' research and development programs and the FDA's approval process aim to ensure both drug safety and efficacy, so it is best to closely follow the instructions for each medication.

Finally, a research study published in 2022 found that when taking pills orally, our body position can make a difference! Essentially, because most pills start to work after they are ejected by the stomach into the intestine, the closer a pill lands to the lower part of the stomach, the faster it dissolves and gets absorbed by the intestine.

Due to the natural asymmetry of the stomach and to gravity, the best body position for this to happen is ... lying on our right side!

Have medication-related questions?

Please know that our pharmacists are available 7 days a week and will work with you and let you know the options for your situation -- just ask:

if you have difficulties with side effects
if you need a refresher on how to use a medication device or how best to take medications
if your medication doesn't seem to be working after a reasonable amount of time

References and resources

*Lymphatics are tissues related to the lymph system, which is part of the immune system and which transport fluids in the body.

National Library of Medicine on medication routes of administration - https://www.ncbi.nlm.nih.gov/books/NBK568677/

National Library of Medicine on transdermal medications - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2700785/

Gensco Pharma on the difference between topical and transdermal medications - https://genscopharma.com/difference-topical-transdermal-medications/

Johns Hopkins Medicine on medication management and safety tips - https://www.hopkinsmedicine.org/health/wellness-and-prevention/help-for-managing-multiple-medications

American Academy of Pediatrics on how to use liquid medicines for children - https://www.healthychildren.org/English/safety-prevention/at-home/medication-safety/Pages/Using-Liquid-Medicines.aspx

Johns Hopkins University Magazine on how posture affects taking pills - https://hub.jhu.edu/2022/08/16/the-best-posture-to-take-a-pill/

A Few Minutes with Mary

Sat, 28 Sep 2024 01:28:20 GMT

September 2024

Meet our multi-faceted pharmacist Mary...

She is a generalist pharmacist, interested in the whole patient and from a professional perspective, all aspects of pharmacy.

As patients who consult with her have experienced, Mary enjoys the challenge of multi-layered questions and she is a great listener. She puts care and attention into figuring out the best options for each patient's situation, taking into account their lifestyle, health conditions, supplements, and of course, prescriptions. Along with her pharmacist colleagues, Mary conducts Medication Therapy Management (MTM)* reviews, which is a thorough review of a person's medications with the objective of ensuring optimal outcomes.

How did you get into pharmacy?

My parents are both pharmacists, as is my sister, so it "runs in the family". I initially wanted to go to law school, but then I got a job as a Pharmacy Technician while in college, and liked it so much that I changed majors.

What is a common misconception about your profession?

The most common misconception about pharmacy is that we just fill prescriptions.

We are able to do so much more now, such as make decisions about what vaccines a patient is eligible for and administer them, consult on and prescribe oral birth control, we can write prescriptions for over the counter medications so that, in some cases, insurance will pay for them, as well as being an easily accessible source for questions about drug interactions, supplements, and even the best insurance options for patients!

The thing I like best about being in retail pharmacy is getting to work with so many different patient populations! We fill prescriptions for people in nursing facilities, new born babies, and even pets (I love getting to see all the different pet names)! Since I recently went through the newborn phase with my own child, I feel a newfound sense of camaraderie with parents dealing with ear infections and diaper rash.

Congratulations on being a new mom! What is a superpower that you would wish for your daughter?

Thank you! It is harder and better than I thought it would be! It's fun to see her learn new skills and discover the world. It also makes me think about the future more and what her life will be like.

I wish for my daughter to have super confidence, in a nice way. So that she can hold her head high, feel secure in who she is and what she can do, always ready to challenge herself to the next level. Super confidence would also give her healthy trust and respect for herself and others, the ability to build positive relationships, engage in life-long learning, and the list goes on.

What interests do you have outside of pharmacy and being a new mom?

I love to spend time with family and our new baby brings us together.

My husband and I love to do DIY projects, in particular with houses, although we haven't had much time for that these days!

I also like to bake and my colleagues love the banana pudding, brownies, and tres leches cakes that I've brought in to share.

If you could have dinner with someone famous, who would it be?

It would be Conan O’Brien! I started watching Late Night in high school and his dry sense of humor has always made me laugh!

Here's what some of Mary's colleagues have commented about working with her:

"Working with Mary is like coming up for a breath of fresh air. Her quirkiness and amazing sense of style only touches the beginning of what an amazing person she is. Having a pharmacist who not only listens to you but teaches you and doesn't make you feel like you're asking too much of her makes the time at work that much more enjoyable. She always has the right words to say to both staff and patients when we're all having a hard time dealing with certain things. She thoroughly explains everything with an understanding that not everyone speaks medicine and doesn't treat us any less. Mary is an impeccable pharmacist and an even better teacher. Let's also not forget that she's a rockstar Mom!"

- Sophy, Pharmacy Technician

"Mary is one of those rare people who can troubleshoot even the toughest issues and find a solution that works for everyone involved. Our patients and staff really appreciate her for that. What we love most is her steady, positive attitude—she's always upbeat, ready to help, and I've never heard her say, 'I'm too busy' or 'I can't help right now.' She's never too busy for anyone, and her willingness and capability shine through every day."

- Jenny, Pharmacist-in-Charge

* To note, Medication Therapy Management (MTM) Reviews are covered by Medicare and generally by other insurance plans as well. Please call us to check your plan or to make an MTM appointment for you or a loved one.

Bad Breath

Fri, 30 Aug 2024 03:38:15 GMT

August 2024

Image credit: Andrea Piacquadio on Pexels

We have all probably experienced this at one point or another... we get a whiff of someone's bad breath and then we think, oh no! What if it's me?!

Called halitosis, bad breath is a frequent or persistent disagreeable smell to one's breath. In most cases, the cause is in the mouth, by bacteria that ferments food debris, producing smelly volatile sulfuric components.

Halitosis can also be caused or aggravated by:

Having garlic, onions, fish, coffee, or alcohol, which can sometimes last for up to 72 hours.

Gum diseases such as periodontitis which allow for bacteria to multiply in the space between teeth and gums.
Tooth decay or faulty fillings can be breeding grounds for bacteria.

Dry mouth and abnormal functioning of the saliva glands. Saliva helps to clean the mouth and when there isn't enough, food particles remain in the mouth for longer.
Smoking or using tobacco products, which can cause dry mouth and which can also increase the chances of gum disease.
Certain medications.
Infections of the nose, throat, or lungs, which increase the presence of bacteria. For example, pneumonia can cause people to cough up liquid that smells bad.
Tonsil stones, which is when food gets stuck in the tonsils (located at the back of the throat) and hardens into calcium deposits.
Gastro-intestinal issues where gastric acid travels up the esophagus, from the stomach.
Liver issues may cause a sweet, musty breath, and kidney issues may cause the smell of urine. Untreated diabetes can result in breath that smells like nail polish remover.

Image credit: Andrea Piacquadio on Pexels

What if you think your breath smells bad?

You can take action, and here are some ideas:

Brush your teeth at least twice a day for two minutes each time, making sure you brush the outside, inside, and top of each tooth;
Use a fluoride toothpaste;
Floss your teeth at least once a day to clean places that a toothbrush can't reach;
Gently brush your tongue when brushing your teeth;
If you wear dentures, keep them clean and remove them at night;
Try using an antibacterial mouthwash or toothpaste;
Avoid alcohol, caffeine, and tobacco products;
Drink water to keep hydrated;
Avoid sugary foods and drinks to help prevent dental plaque; and
Get regular dental cleanings and check-ups. Dentists are trained to watch out for issues in and around the mouth and will let you know if an appointment with a doctor or a dental specialist is needed.

Since people of all ages can get bad breath, watching for it in kids could help prevent embarrassment or low self-esteem, and potentially catch any underlying health issues early.

Chewing gum and breath mints can help temporarily, but they mostly only cover up the problem. A good starting point to address bad breath that doesn't go away is to make a cleaning appointment with a dentist and ask for a halitosis assessment.

After all, longer term peace of mind is worth it!

References and resources

Mayo Clinic on bad breath - https://www.mayoclinic.org/diseases-conditions/bad-breath/diagnosis-treatment/drc-20350925

The National Health Service of the UK on Bad Breath - https://www.nhs.uk/conditions/bad-breath/

Cleveland Clinic on bad breath - https://my.clevelandclinic.org/health/diseases/17771-bad-breath-halitosis

Did you know?

Fri, 19 Jul 2024 00:50:00 GMT

July 2024

In our monthly email newsletter, we often have a section entitled "Did you know?". As the heading suggests, it's usually about a little known or surprising fact. Here's a selection of them!

You can subscribe to our monthly email at the very bottom of this page. Your subscription information is only used for this purpose and we do not sell your information. You can unsubscribe at any time by clicking on the "unsubscribe" button at the bottom of each of our emails or by just letting us know.

Preventing Germs from Spreading

Handwashing as a means to prevent the spread of germs was first discovered in 1847 by a Hungarian-German physician, Dr. Ignaz Semmelweis.

Working in the obstetric clinic in Vienna, he observed that women in the 1st division of the clinic died at rates 2 to 3 times higher than women in the 2nd division. They died of puerperal infection, or childbed fever, a major problem of maternity hospitals in Europe at the time. The two divisions were identical except that students were taught in the 1st and midwives in the 2nd.

The breakthrough occurred when Semmelweis' good friend Jakob Kolletschka died from a wound infection, having been accidentally poked with a student's scalpel while performing a post mortem examination. Kolletschka's autopsy showed a pathology similar to that of the women who were dying from puerperal fever and Semmelweis immediately proposed that students who came directly from the dissecting room to the maternity ward carried the infection with them.

He ordered the students to wash their hands in a solution of chlorinated lime before going to the maternity ward and the mortality rates in the 1st division immediately dropped dramatically. Semmelweis also reduced mortality rates at an obstetric ward where he subsequently worked in Pest, but because his ideas conflicted with established scientific and medical opinions of the time, they were rejected by the medical community and many physicians continued to practice without washing their hands.

It wasn't until 20 years later, when the germ theory of disease was accepted thanks to the work of Louis Pasteur, were Semmelweis' observations confirmed by theory.

References:

Soap

The earliest recorded evidence of the production of soap-like materials dates back to circa 2800 B.C., where a formula consisting of water, alkali, and cassia oil was written on an ancient Bablyonian clay tablet.

Societies from ancient times to the present use soap: ancient Egypt, ancient Israel, ancient China, ancient Arabs, the Islamic Middle East, Medieval Europe, etc.. The name for soap is derived from its original Celtic name, "saipo".

Here is a link to a great explanation of how soap works and why it's better to wash your hands rather than use hand sanitizer when you can:

https://www.theguardian.com/commentisfree/2020/mar/12/science-soap-kills-coronavirus-alcohol-based-disinfectants

References:

https://en.wikipedia.org/wiki/Soap
http://www.soaphistory.net/soap-history/first-soap/

Fat is Not Created Equal

As people go through their middle years, their proportion of fat to body weight tends to increase. We would like to bring your attention to differences in two types of fat that the body produces: visceral (or abdominal) fat and subcutaneous (below the skin) fat.

Visceral fat, which is fat deep in the abdomen, is of more concern than the fat that you can pinch with your fingers, which is subcutaneous fat. Visceral fat lies beneath the abdominal wall, in the spaces surrounding the internal organs.

The fat cell acts as an endocrine gland, secreting hormones and other molecules that affect other tissues. Visceral fat produces a higher proportion of molecules that are potentially harmful to our health while subcutaneous fat produces a higher proportion of beneficial molecules.

Visceral fat makes more of the proteins called cytokines, which can trigger low-level inflammation, a risk factor for heart disease and other chronic conditions. It also produces a precurser to angiotensin, a protein that causes blood vessels to constrict and blood pressure to rise. Compared to subcutaneous fat, visceral fat secretes more of retinol-binding protein 4 (RBP4), a molecule that increases insulin resistance.

Thus, visceral fat has been linked to certain chronic conditions, including:

Cardiovascular disease
Dementia
Asthma
Type 2 diabetes
Abnormal cholesterol
Breast cancer
Colorectal cancer

Subcutaneous fat produces more of certain beneficial molecules, including the hormone leptin, which acts on the brain to suppress appetite and burn stored fat. Adiponectin, another hormone produced mainly by subcutaneous fat, helps protect against diabetes by regulating the processing of fats and sugars; it also has an anti-inflammatory effect on the linings of blood vessels.

We cannot control where we gain fat on our bodies as it depends on our genes, hormones, and age, among other factors. We can take measurements such as body weight and body mass index (BMI), but that is not sufficient; knowing where fat is distributed is also important.

You may have already guessed: the secret to reducing visceral fat is physical activity and a healthy diet.

To note, we can't control where we lose weight specifically and liposuction doesn’t reach inside the abdominal wall. The good news, though, is that increasing physical activity and eating healthy come with other great side effects, including better quality of life.

For our perspective on physical activity, take a look at our blog on this topic:

https://www.thepharmacyatwellington.com/back-to-basics-physical-activity/

We are more than happy to work with you on measuring your waistline and/or discussing options for lifestyle changes -- just drop by!

References:

Preventing Chapped Lips

Jenny, one of our friendly and knowledgeable pharmacists, debunks the myth that certain lip balms and lotions can cause addiction.

She confirms, "They do not contain ingredients that cause addiction. However, repeat exposure to an allergen or irritant in them may cause a rash on your lips, and if you continue to apply it, you create a vicious cycle that may feel like an addiction."

Common culprits that may be allergens or irritants include:

Alcohol (also listed as OL)
Phenol
Menthol
Salicylic acid
Citrus
Mint
Tea tree oil
Eucalyptus
Camphor
Lanolin

The fewer the ingredients that a lip balm or lotion has, the less likelihood it will cause irritation or an allergic reaction. A lip product with only petroleum (Vaseline) will just be a barrier, to seal in moisture, and those with beeswax and lanolin will also help seal in moisture.

For people with severe lip irritation and who need a strong product, there is Cortibalm, which comes in lip balm stick format. It contains 1% hydrocortisone and is recommended for acute, severe cases and is not to be used every day.

Jenny also recommends the following non-pharmaceutical solutions:

Stay hydrated
Have Omega-3 fatty acids (eat fish or take fish oil); it keeps skin hydrated
Don't lick your lips
Don't pick at flakey lips
Wash your hands before and after applying lip product, especially if you use your finger to apply it
Breathe through your nose
Avoid irritants or allergens in cosmetics
Use sunscreen on your lips when outside in sunny weather

References:

Fun Brain Facts

There are about 400 miles of capillaries in the human brain! Each of the 100 billion neurons in the brain has its own capillary. And even though the brain is only 2% of our body weight, it receives 15% to 20% of the body's blood supply.

Brain cells need oxygen, transported by blood, to stay alive. The body attemps to supply the brain with a constant flow of blood even if other organs need blood. Blood also removes materials from the brain (carbon dioxide, ammonia, lactate, etc.).

Each neuron only generates a tiny bit of electricity but altogether the brain can power a 20 watt light bulb! Neurons communicate with each other using chemical and electrical signals and our light bulb is on all the time, whether we're awake or asleep ��

References:

Chickenpox and Shingles

Sun, 30 Jun 2024 22:16:34 GMT

June 2024

Image credit: CDC's Public Health Image Library

With greater awareness of vaccines in the last few years, we thought it might be useful to review chickenpox (varicella) and shingles (zoster), two related diseases. We hope that this information will help prevent these uncomfortable, painful, and sometimes serious diseases from spreading in our community.

How are shingles and chickenpox related?

Before the chickenpox vaccine became widely available in 1995, kids would get chickenpox, a highly contagious disease that would keep them home for about a week. They'd have a rash that turned into itchy, fluid-filled blisters that would eventually become scabs.

Once a person has had chickenpox, the virus, varicella zoster, stays in their system. Years later, it can reactivate when the person's immune system starts to weaken due to age, fatigue, medications, or medical conditions, causing shingles. To note, people who have never had chickenpox can still get shingles from someone who has shingles (see the section on Spreading below). Also, not everyone who has had chickenpox will develop shingles.

Shingles typically involves an itchy and painful band-like rash on one side of the chest, abdomen, back, face or head, arm, or leg. The rash is usually very painful and lasts about a week to 10 days.

To note, the varicella zoster virus (VZV) is part of a group of viruses called herpes viruses, which includes viruses that cause cold sores and genital herpes. However, cold sores and genital herpes are caused by a different virus from VZV.

What increases the chances of getting shingles?

Factors that can increase the risk of developing shingles include:

Age - typically higher risk over the age of 50
Diseases or treatments that weaken the immune system - such as HIV/AIDS, cancer, Crohn's disease, rheumatoid arthritis, etc.
Some medications - such as drugs that prevent the rejection of transplanted organs. Long-term use of steroids can also increase the risk of developing shingles.
Older people who have head trauma - are more likely to get shingles than younger people who get head trauma. Medical professionals have made this correlation but it isn't fully understood yet.

What are the different vaccines available for shingles and for chickenpox?

The chickenpox vaccine is recommended for babies between 12 and 15 months.

For children and adults who do not have evidence of immunity to chickenpox, the CDC (Centres for Disease Control and Prevention) recommends two doses of Varivax, the vaccine against chickenpox, 4 to 8 weeks apart.

Shingrix, the vaccine against shingles, is also a 2-dose series and is recommended for people who:

are 19 years of age and older and who have weakened immune systems
are aged 50+

To note, even though adults younger than 50 years old get shingles, Shingrix has not been studied in people under 50, so it is not clear how effective the vaccine is for lowering the risk of recurrent shingles for younger adults.

Some kids who get the chickenpox vaccine still contract the disease, but they usually have milder symptoms. Similarly, some adults who get the shingles vaccines still contract the disease, but their symptoms can be milder.

Talk with your doctor or one of our pharmacists if you have any questions about these vaccines or whether they are covered by your insurance.

Image credit: CDC's Public Health Image Library

Keeping shingles and chickenpox from spreading

Both chickenpox and shingles can cause serious health issues, so it is best to do what we can to keep both from spreading.

Complications from chickenpox can include: streptococcal infections, pneumonia, encephalitis (shingles can cause this too), hemorrhagic complications, sepsis, etc.

If a person gets shingles on the head, it can infect the eyes, which can cause vision problems or even vision loss. About 1 in 10 people who get shingles develop nerve pain that can last for months or years after the rash goes away. Shingles can also cause facial paralysis, problems with hearing, or balance.

People who haven't had chickenpox or the chickenpox vaccine can get infected with VZV through direct contact with the fluid in shingles rash blisters or by breathing in virus particles from the blisters. 10 to 21 days after exposure, the person would develop chickenpox (not shingles) and later run the risk of getting shingles.

People who have an active case of shingles rash should stay away from others and especially from babies under 12 months old as they cannot receive the chickenpox vaccine until that age. Others to avoid include pregnant people and people with weakened immune systems. Covering the rash, avoiding touching or scratching it, and washing hands often are also good practices.

If you or a loved one has a rash that could be shingles, see your doctor as soon as possible. The sooner treatment is started, the better the duration and severity of the infection.

The best protection against getting chickenpox or shingles is getting vaccinated and staying away from anyone who is actively infected with these diseases.

So, if you're waiting for the covid vaccine to be available again (expected in the fall), it might be a good idea to look into whether getting a shingles vaccine in the meantime is right for you. This would give your body the opportunity to process one vaccine at a time.

Please feel free to drop by and ask one of our pharmacists about your specific situation. We're here for you!

References and resources

American Medical Association on what doctors wish patients knew about shingles - https://www.ama-assn.org/delivering-care/public-health/what-doctors-wish-patients-knew-about-shingles-virus

CDC on chickenpox - https://www.cdc.gov/chickenpox/about/index.html

Mayo Clinic on shingles - https://www.mayoclinic.org/diseases-conditions/shingles/symptoms-causes/syc-20353054

CDC on Shingrix - https://www.cdc.gov/vaccines/vpd/shingles/hcp/shingrix/recommendations.html

Mayo Clinic on getting shingles under 50 - https://newsnetwork.mayoclinic.org/discussion/shingles-more-common-after-age-50-but-can-affect-younger-people-as-well/

CDC on shingles - https://www.cdc.gov/shingles/about/index.html

Johns Hopkins Health on shingles - https://www.hopkinsmedicine.org/health/conditions-and-diseases/shingles

Thank you to our friend Erin A. who gave us the idea for this blog post!

Melatonin and sleep

Thu, 30 May 2024 00:22:44 GMT

May 2024

Image credit: Ketut Subiyanto on Pexels

As we move into travel season and people are going farther distances, we've had more questions about the sleep aid and hormone melatonin. Does it work for jet lag? How does it work? What are side effects? Should I use it? We thought we'd delve into the topic of melatonin for this month's blog.

What is melatonin? What does it do?

Isolated in 1958 by Aaron B. Lerner, a dermatology professor, and his team at Yale University, melatonin is a hormone produced by the pineal gland, which is a small pinecone shaped gland located behind the thalamus in our brains. The pineal gland is part of the endocrine system, which makes and releases hormones, chemicals that coordinate different functions in our bodies by travelling via the circulatory system and sending signals to our organs, skin, muscles, and other tissues.

Melatonin helps to regulate the sleep-wake cycle. Our bodies produce higher levels of melatonin at nightfall, when daylight diminishes, reaching maximum production at the early hours of the morning. The initial effects of the increased levels of the hormone are to make us drowsy, facilitating sleep.

What do our bodies use to produce melatonin?

Melatonin is produced in our bodies from tryptophan, an amino acid found in foods that we eat. Incidentally, tryptophan is also used by our bodies to produce other hormones (serotonin, which helps to regulate appetite, sleep, mood, and pain) and vitamins (niacin, or B3, used for energy metabolism and DNA production). Examples of foods containing tryptophan include:

cheese
chicken
egg whites
fish
milk
sunflower seeds
peanuts
pumpkin seeds
sesame seeds
soy beans

Image credit: Anna Schvet on Pexels

The amount of melatonin produced varies from person to person, and scientists have observed that more melatonin is produced when the pineal gland is bigger. We don't completely understand the impact of that, but we know that the amount of melatonin produced varies as a function of the size of the pineal gland.

Melatonin is known to have anti-inflammatory effects, as well as the ability to regulate sugar in our bodies. An excess of melatonin can lead to an intolerance of sugar and potentially lead to diabetes.

It has been observed that age has an impact on the amount of melatonin produced -- the older a person is, the less melatonin their body produces. This could be caused by factors such as the age of the pineal gland itself and a diminished capability, or the presence of cataracts. Cataracts prevent daylight from entering the eyes so the receptors in the retina which signal the body to produce melatonin aren't stimulated.

Certain medications can also reduce melatonin production, for example some sedatives used to promote sleep, some anti-inflammatory medications, and some beta blockers. Certain sedatives which require higher doses over time because of increases in tolerance may also deregulate our melatonin cycle.

On the flip side, melatonin can reduce the effectiveness of certain medications, in particular certain anti-depressants, and it can enhance the effect of others, for example, some diabetes medications.

Melatonin can also affect certain conditions negatively, for example, it can worsen certain rheumatic diseases.

Please feel free to consult with our pharmacists if you have any questions about melatonin and drug interactions or specific conditions, as each situation is unique.

Image credit: Ketut Subiyanto on Pexels

What does all this mean for using melatonin as a sleep aid?

Our bodies don't develop a tolerance for melatonin (building tolerance means needing to take more over time to have the same effect), nor do we get addicted to it, and our bodies don't go through withdrawal symptoms when we stop taking melatonin. Despite these positive points, we still need to be very careful about taking it.

In some individuals, for example, taking even a small dose can lead to higher-than-normal levels of melatonin in their body, potentially bringing on side effects such as headaches, nightmares, dizziness, sleepwalking, or nausea. Higher doses of melatonin could raise blood-sugar levels, especially for individuals who are already prone to diabetes.

Less common melatonin side effects may include:

short-lasting feelings of depression
mild tremor
mild anxiety
abdominal cramps
irritability
reduced alertness
confusion or disorientation

Scientific studies, including meta-analyses, show that melatonin can help individuals fall asleep faster, which could increase the total sleep time. The difference is not great, but it is statistically significant.

Its effectiveness depends on the dosage, when it's taken, on the person's age, and individual predispositions. There are some people who respond better to it than others.

Good bedtime habits are always recommended - take a look at one of our past blogs, on sleep:

Recommendations for taking melatonin as a sleep aid for adults and children include:

Take it on an empty stomach so that it can be better absorbed by the body.
Take it 30 to 120 minutes before going to bed. The ideal timeframe is likely around 60 to 90 minutes.

At this point, there is not enough information about the effect of melatonin use on fetuses, so it is not recommended for pregnant individuals.

Also keep in mind that melatonin is classified as a dietary supplement by the U.S. Food and Drug Administration (FDA), which means that it is regulated less strictly than a prescription or an over-the-counter drug would be. In certain other countries, for example the UK, it is considered a medication and can only be obtained with a prescription.

What's the bottom line?

If you would like to use melatonin as a sleep aid on a longer-term basis, discuss this with your doctor.

Having it available with you for jet lag could be a good strategy for getting on a new time zone more quickly. We would still recommend that you speak with a health professional about doing so, just to double check how it might affect your individual situation.

Our pharmacists are more than happy to review your or a loved one's situation -- just drop by.

References and resources

Wikipedia on melatonin - https://en.wikipedia.org/wiki/Melatonin

National Library of Medicine on tryptophan - https://medlineplus.gov/ency/article/002332.htm

Radio Canada on myths and realities of melatonin - https://ici.radio-canada.ca/ohdio/premiere/emissions/penelope/segments/chronique/486084/hormone-sommeil-explications-melatonine

Wikipedia article about melatonin - https://en.wikipedia.org/wiki/Melatonin

Mayo Clinic on melatonin - https://www.mayoclinic.org/drugs-supplements-melatonin/art-20363071
The U.S. National Center for Complimentary and Integrative Health on melatonin - https://www.nccih.nih.gov/health/melatonin-what-you-need-to-know
Johns Hopkins Medicine on Melatonin for Sleep - https://www.hopkinsmedicine.org/health/wellness-and-prevention/melatonin-for-sleep-does-it-work

Cleveland Clinic on melatonin - https://my.clevelandclinic.org/health/articles/23411-melatonin

National Library of Medicine on melatonin - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4334454/

Mount Sinai on melatonin - https://www.mountsinai.org/health-library/supplement/melatonin

Weight training and women

Tue, 30 Apr 2024 16:41:53 GMT

April 2024

Image credit: Yan Krukau on Pexels

A typical image that comes to mind when we think of a gym is one filled with fairly young and fit bodies, with motivating trainers here and there, and mostly male but more females in the last decades.

We intuitively know that strength training is good for our muscles and general health -- now a scientific study (March 2024) shows that women who do strength training exercises 2 to 3 days a week are more likely to live longer and have a lower risk of death from heart disease, compared to women who do none.

What is strength training or resistance training?

According to the American College of Sports Medicine, it is "a form of physical activity that is designed to improve muscular fitness by exercising a muscle or muscle group against external resistance." That means applying a load to a muscle that is heavy enough to cause the muscle to adapt, increasing the muscle's strength.

Strength training:

improves bone density - activities that put stress on bones can nudge bone-forming cells into action. That stress comes from the tugging and pushing on bone that occur during strength training. The result is stronger, denser bones.
keeps the joints in proper alignment - which in turn promotes better stability
helps to improve sports performance - who wouldn't like to be a stronger pickle ball player!
reduces the risk of injury - stronger muscles and bones and better balance all contribute to decreasing the risk of falls
can help with posture - by strengthening relevant muscles
doesn't cause muscles to bulk up in women - unless this is one of your goals, in which case you'd need to make other changes as well (talk with a trainer about how)
when added to an existing cardio routine can accelerate fat loss by increasing metabolic effects. That is, muscles require energy.
improves quality of life - another great reason to start it, even in our later years

Image credit: kampus on Pexels

In the March 2024 study, cardiovascular mortality rates for the women who regularly did muscle strengthening were reduced by 30%! That's enough to provide strong motivation to start or continue strength training!

Another surprising finding is that it women need less exercise than men to get the boost in longevity. More studies are needed to determine the cause of this, but hey ladies, we have an advantage!

Here are some tips:

Find a way to make it fun for you -
if you prefer, make it social (enroll a friend to join you, or do a class)
or, if you'd rather view it as ME time, block out time for it in your calendar
Do strength training exercises that you like and figure out a location and routine that works for you -
this can mean using bands and balls
or your own weight for resistance (for example push-ups, squats, holding arms out to the side, etc.)
or maybe you prefer weight machines at the gym
Try to work out most muscles -
including upper body, core, and lower body
as well as left and right sides, front and back of the body
Don't worry about having to do a perfect workout every single time because each day may be different, depending on how we slept, how much energy we have, if we're stressed about something, etc. -
Do have good form - consider getting professional help so that you don't cause injury. Make sure to let your doctor know you're doing strength training. Also, most gyms and physical therapy clinics have or can recommend certified trainers.
Do take into account any health issues - strength training should accommodate for existing conditions.
Do consider progression - continuous or constantly increasing intensity may not lead to progress. Talk with a trainer to determine how best to do strength training so that your physical condition improves.
Do stick with it - it's really the only way to see and feel tangible benefits.

Image credit: Pavel Danilyuk on Pexels

What is the ONE thing you can do to improve your health?

References and Resources

NPR on the new study - https://www.npr.org/sections/health-shots/2024/03/11/1236791784/strength-resistance-weight-training-longevity-aging-heart-disease
NPR on the benefits of strength training - https://www.npr.org/2024/03/11/1237665808/strength-training-does-more-than-build-muscle-its-hidden-benefits-are-massive

Harvard Health Publishing on the effects of strength building - https://www.health.harvard.edu/staying-healthy/strength-training-builds-more-than-muscles

National Library of Medicine on barriers to resistance training among college women - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5955292/

Hospital for Special Surgery on how exercise can help build better bones - https://www.hss.edu/article_exercise-for-bone-health.asp

Hospital for Special Surgery on the benefits of strength training for women throughout life - https://www.hss.edu/article_benefits-strength-training-for-women.asp

Northwestern Medicine on the importance of strength training for women - https://www.nm.org/healthbeat/healthy-tips/fitness/women-who-lift

Mayo Clinic on weight training tips for beginners - https://newsnetwork.mayoclinic.org/discussion/weight-training/?mc_id=us&utm_source=pes&utm_medium=e&utm_content=engagement&utm_campaign=mayoclinic&geo=national&placementsite=enterprise&invsrc=patloy&cauid=122853

International Women's Day

Fri, 08 Mar 2024 01:16:53 GMT

March 2024

Image credit: pikisuperstar on Freepik

March 8, 2024 marks International Women's Day. We thought it might be interesting to cover a few health-related topics relevant to half the population for this special day.

Apple's Health App originally didn't track periods

Some of you might have noticed that when Apple came out with their Health App on the iPhone, back in September 2014, it didn't include any way to track a woman's menstrual cycle. Several rumors circulated about how or why Apple overlooked the feature:

it was because there wasn't a woman on the team that came up with the Health App idea, or
the app was meant to provide a neutral experience, or
Apple thought that people wouldn't be interested in such a feature, etc.

It is interesting to note that even when an updated version of the app was released, as late as March 2015, it still did not have that feature, even though by that time, many people had notified Apple about the omission. Thankfully, today's version of Apple's Health App does provide a way to track menstrual cycles.

Why is it relevant for a woman to track her period?

Menstruation cycles are different for each woman. While it is hypothesized that women who spend a lot of time together have cycles that match, this hasn't been proven to always be the case, so each woman will want to track her own cycle.

Changes can happen in a woman's menstrual cycle. A period can be early, late, skipped, regular or irregular, painful or not. A period can be heavy, medium, or light. Information about periods can give valuable insight into a woman's health.

Some women use their ovulation cycle as an additional birth control strategy. On the flip side, women trying to get pregnant will also watch their menstruation cycle very closely.

Heart attacks -- how are symptoms different for women?

Generally, signs of a heart attack are:

Chest pain, but not always
Pain or pressure in the lower chest or upper abdomen
Jaw, neck or upper back pain
Nausea or vomiting
Shortness of breath
Fainting
Feeling a cold sweat
Indigestion
Extreme fatigue

Differences for women can include the following:

Women are more likely to have more than one heart attack symptom. For example, extreme fatigue and nausea or vomiting. Some women actually have less obvious warning signs.
Many women may feel "off" before they had a heart attack, without being able to pinpoint why.
Some women may describe chest pain in different ways. For some, it may feel more like pressure. For others, it can be a tightness.
Some women reported issues with sleep in the weeks prior to a heart attack: difficulty getting to sleep, unusual waking throughout the night, feeling tired despite getting enough sleep.
Some women may feel pain or pressure in the stomach before a heart attack.

Stroke -- how are signs different for women?

Generally, signs of a stroke can include:

Numbness or weakness in face, arm or leg
Trouble speaking or understanding speech
Vision problems
Trouble walking or a lack of coordination or balance
Severe headache without a known cause

In women, additional symptoms can also include:

Disorientation and confusion or memory problems
Fatigue
Nausea or vomiting

It is vitally important for a woman experiencing heart attack or stroke symptoms to get medical help. It's not the time to blame such symptoms on just normal aging, the flu, or acid reflux.

Image credit: kjpargeter2018 on Vecteezy

Medical research and women

Historically, medical studies have been based on men's health likely due to two somewhat opposing beliefs: that men and women's bodies work the same way, and/or that the menstrual cycle introduces too many variables into studies. Thus, studies tended to exclude female participants and the resulting research conclusions were simply generalized to females. We all know that male and female bodies are different and although taking the shortcut of excluding females may seem logical for controlled studies, it could also be that scientists don't yet understand the extent of the differences.

While researchers are increasingly aware of this issue, the consequences of historical actions will take some time to work through. For example:

Women being misdiagnosed or not diagnosed based on "typical" (read "male") symptoms and thus potentially receiving delayed, irrelevant or potentially harmful treatment for their particular situation. Or being told that their complaint is "all in their head".
The lack of funding for research that includes women's health may result in more expensive, invasive, and/or complicated treatment due to issues with diagnosis and/or a time factor.

Bottom line

It is just as important for men as it is for women to be open to learning more about women's health issues because they affect our mothers, daughters, sisters, wives, aunts, and grandmothers.

Better understanding will hopefully help to reduce gender biases -- we need to be aware of it before being able to do something about it!

References and resources:

Articles about the "tampon tax" in the U.S.:
https://www.nbcnews.com/health/womens-health/where-tampons-pads-period-products-are-taxed-map-rcna132874
https://www.cbsnews.com/news/tampon-tax-feminine-hygiene-products-sales-tax/

Our Eyes and the Eclipse

Tue, 27 Feb 2024 23:16:37 GMT

February 2024

Knowledge is power, as they say, and today's blog is intended to help us do our homework in preparation for the upcoming solar eclipse which will be visible from Arkansas. It will be on Monday, April 8, 2024, at around 12:30 p.m. to 1:50 p.m., depending on one's location and the percentage of the sun eclipsed.

Can I look at the sun directly whether there's an eclipse or not?

Since exposure to the sun's ultraviolet (UV) light can cause permanent damage in less than a minute, the prudent answer is "no".

What happens if I do look at the sun directly? If there's damage, why doesn't it hurt?

Our eyes' retina captures light and converts the signal to one that our brain uses to interpret the image we see. The retina, however, is vulnerable to damage by light, also called photochemical damage.

Since the retina does not have any pain receptors, we can't tell if we're looking at the sun long enough to cause damage. Sometimes, damage doesn't become evident until hours afterwards or even the next day. The retina's photoreceptors can function a bit before they become disabled or die.

Can I look at the sun during the few seconds where there is a total eclipse?

It is best not to do so since the pupils will be more dilated during those few seconds of darkness and the first rays that come through could penetrate the eye more easily and cause damage. It is difficult to time it just right, to stop looking at a full eclipse just a moment before the moon doesn't block out the sun completely. The risk to our eyes is not worth it.

What kind of eye damage can occur due to exposure to UV rays?

The various diseases include:

Pterygium - a growth on the cornea (the cornea is a vital protective layer of the eye, at the front of the eye) that can cause vision impairment in the later stages of the disease. This disease is more common when a person spends hours outside during the day (for example, surfers, skiers, fishermen, farmers, outside construction workers, etc.).

Cataracts - this is when the eye's natural lens becomes cloudy. Symptoms include blurry vision, seeing double, being extra sensitive to light, having trouble seeing well at night, and seeing bright colors as faded or yellow.

Macular Degeneration (MD) - the macula, the part of the retina that processes our central vision, allows us to focus on small details in front of us. In MD, the macula is damaged and we gradually lose vision from the center of the picture in front of us. With MD, over time we gradually lose more and more vision, moving out from the center.

Solar retinopathy, or "eclipse retinopathy" - caused by looking at the sun directly or indirectly during an eclipse, can result in blurry vision or a blind spot. Vision often recovers back to normal levels between 3 and 9 months, although sometimes damage is irreversible.

To note, the lenses in children's eyes are more transparent, letting in more UV light, so it's even more important to protect their eyes against the sun's UV rays, especially when considering that cumulative exposure can be very damaging.

What can I do to prevent eye damage due to UV rays?

Multiple precautions can help and utilizing several at the same time will provide more protection. Options include:

wearing a hat with a wide brim
wearing glasses with coatings that block UV rays
wearing sunglasses and/or contact lenses with UV filters
wearing skiing goggles when skiing
wearing eclipse viewing glasses as they are specially designed to absorb 99.9% of the sunlight (regular sunglasses typically absorb about 90%)
avoiding going outside when the sun is at its strongest, from midday to early afternoon
being extra careful when outside at higher altitudes, when around water, ice, or snow

Bottom line

Don't turn a blind eye to the potential dangers of eye exposure to sunlight.

Let's hope that April 8th won't be a cloudy day! We have a supply of eclipse glasses at the pharmacy -- drop by to pick some up, or add them to your prescription delivery.

References and resources:

National Eclipse on viewing in Arkansas - https://nationaleclipse.com/states/2024-total-solar-eclipse-arkansas.html

American Academy of Ophthalmology on cataracts - https://www.aao.org/eye-health/diseases/what-are-cataracts

Cleveland Clinic on the macula - https://my.clevelandclinic.org/health/body/23185-macula

Cleveland Clinic on the cornea - https://my.clevelandclinic.org/health/body/21562-cornea

National Library of Medicine, article Effects of Solar Radiation on the Eyes - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9709587/

National Geographic on protecting our eyes from the sun - https://www.nationalgeographic.com/science/article/sun-damage-eyes-solar-eclipse-protection
American Academy of Ophthalmology on the sun, UV light, and your eyes - https://www.aao.org/eye-health/tips-prevention/sun

Mayo Clinic on eyes and the eclipse - https://newsnetwork.mayoclinic.org/discussion/eyes-on-the-eclipse-serious-damage-can-occur-from-staring-at-the-sun/

American Academy of Ophthalmology on solar retinopathy - https://eyewiki.aao.org/Solar_Retinopathy

Wikipedia article on the retina - https://en.wikipedia.org/wiki/Retina

Macular Degeneration Research on whether bright lights are damaging to the eye - https://www.brightfocus.org/macular/article/are-bright-lights-damaging-eye

National Library of Medicine article on photochemical damage of the retina - https://pubmed.ncbi.nlm.nih.gov/16950247/

National Library of Medicine abstract about photochemical damage of the retina - https://pubmed.ncbi.nlm.nih.gov/16950247/

Spotlight on Susan

Wed, 31 Jan 2024 21:51:40 GMT

January 2024

We know Susan to be the reliable, knowledgeable, and professional pharmacist that she is, but we had the feeling that there is more depth to her than at first impression.

As you may have seen on the "About Us" page of this website, Susan grew up living and travelling all over the U.S. and Europe as her dad was in the Air Force. She learned to adapt to various environments and people and we see this part of Susan's background shine through on a daily basis, as she actively listens to and interacts with patients and providers, never losing patience. Working with her, we very much enjoy her steady disposition and openness to different viewpoints.

"It takes a village to raise a child"

And Susan is an integral part of that village, mentoring the children of friends. She has been doing this for years as some of those kids are almost adults! As an informal big sister, Susan finds ...

Volunteering

Susan helps out at her Methodist church and also at Harmony Health Clinic, which many of us at The Pharmacy also support wholeheartedly. It is a free medical and dental clinic in Little Rock for the uninsured and under-insured.

She also enjoys spending time with her parents, who appreciate her help as well.

What is a little-known fact about you, Susan?

When I was studying in pharmacy school, I had to keep my hands busy while studying. So, I would stand and focus on reading my notes, and at the same time have yo-yos in my hands so that they'd be occupied!

My brother gave me a yo-yo machined out of titanium once, that he had found and bought from a San Francisco yo-yo shop, pre-internet. I was proud of having such a high-quality yo-yo -- the better ones are made so that they have minimal drag. There are also yo-yos made with specific levels of friction, for specific tricks.

When I get into something and focus on it, I tend to want to know everything about it. This was also the case with collecting wines, although that particular tendency has been put into check since covid.

And yes, I can still do some yo-yo tricks!

If you weren't a pharmacist, what would you be?

I'd be an English major graduate, specializing in Southern literature! I went to Ol' Miss and I would have been content surrounded by historical Southern figures, except that I chose pharmacy because of an interest piqued by perusing my grandmother's copy of the Physician's Desk Reference, a book that included photos and descriptions of medications. Today, I like to read biographies and mostly non-fiction. I prefer older non-fiction, classics, mostly about the South.

What are humans' best invention to date?

The internet. We have so much information at our fingertips. When I was about 10 years old, my parents bought an encyclopaedia set and I read it as a child, from A to Z.

One thing that I remember from it is that if a cow has twins and they are a male and a female, that the female twin is always sterile. The reason was discovered in the 1800's -- because placenta membranes often merge when a heifer has twins, the two calves end up sharing proteins and other molecules. This renders the female twin infertile and reduces the fertility of the male twin.

This happens in certain animals, such as pigs, cows, and goats.

If you had a superpower, what would it be?

Teleportation. It wouldn't include time travel, but just being able to go from one location to another instantly, to be able to pop in for dinner, for example. It takes too long to get to a place!

What are your thoughts about travel?

Having been to almost all the world's continents, I have to say that the U.S. has wonderful places to see. You don't have to go abroad to see amazing things.

My next trip will be to upstate New York and the Great Lakes area in the spring. I look forward to seeing Cooperstown and other quaint villages and towns in that area. If anyone has travel tips for that area, please let me know!

What is a common misconception about pharmacists?

The education that we must go through. People often don't realize the difference between a pharmacy technician and a pharmacist. While technicians are part of the backbone of pharmacy, pharmacists are highly trained in our field.

After obtaining a bachelor's degree, we do 4 years of specialized training and finish with a doctorate in pharmacy. We are exposed to various medical environments (hospital, retail, research, industry, etc.) through internships and we specialize after graduating.

We work closely with physicians and both professions now have more exposure to each other during their training. When consulting with a patient in a retail setting, we may discuss medication options that the patient then brings up with his/her physicians. We enjoy playing a key role in a patient's health team, pulling for the best outcome for each patient.

Back to Basics: Breathing

Tue, 26 Dec 2023 14:56:21 GMT

December 2023

Breathing is something we do throughout our lives, about 12 to 20 times every minute, or 17,000 to 30,000 times or more a day! So why should we pay attention to something that is so basic and natural, something that our body knows how to do already?

Interestingly, people have recognized the importance of breathing since ancient times. The Chinese call the energy of breath qi (pronounced "chee"). The Sanskrit word for life breath is prana and pranayama, or "controlled breathing", is a type of yoga practice.

While this interest in breathing has historical roots, more recently, scientists have been discovering how breathing affects our bodies. (See second link in the References and Resources section below, to the Smithsonian Magazine.) Surprisingly, the actual brain mechanism that controls the diaphragm and breathing is still not 100% understood, nor what controls respiratory rhythm. Scientists will undoubtedly find more answers with time.

In the meantime, a quick internet search came up with benefits to deep breathing such as these (besides keeping us alive!):

emotional mindfulness
reduced anxiety
decreased pain
better memory
lower blood pressure
lower heart rate
reduced side stitches (side pains when exercising)
improved mental and emotional health
improved circulation

Our lungs contain about 500 million tiny sacs called alveoli. It is in the walls of these alveoli that oxygen moves from inhaled air to our blood and that carbon dioxide, a waste gas, moves from our blood to the lungs and is exhaled. This gas exchange is essential to our lives.

How fast and how deeply we breathe is associated with various factors: our feelings, our surroundings, our mental state, etc. If we are frightened, tense, or stressed, for example, our sympathetic nervous system kicks in and our bodies accelerate our adrenal glands and cortisol levels, amongst other reactions, in a "flight or fight" mode. In this type of situation, our breathing tends to be faster and more shallow.

In contrast, the parasympathetic nervous system promotes a state of calmness, giving us a relaxing effect. Controlled breathing, also referred to as belly breathing or abdominal breathing, is associated with stimulating the parasympathetic nervous system. Controlled breathing involves a deep, slow intake of air that expands the diaphragm downwards and draws air deep into the lungs, pushing the belly out as the lungs fill with air, followed by a long, controlled breath out as the diaphragm muscle relaxes and air blows out.

"Breathe in the good, breathe out the bad"

It is recommended to take long, deep breaths from time to time, as needed or as part of a breathing program, and here are some guidelines (consult with your doctor before starting such a program, especially if you have asthma, a lung, or heart condition):

Find a comfortable position, lying down if possible. Place a hand on your belly. It should rise (extend) as you take a big breath and fall (retract) as you let air out slowly, over a period of several seconds.
Breathe in through your nose and out through your mouth.
Let your shoulder and neck relax with the movement in your abdomen.
Repeat

When is it best to consciously breathe deeply?

People have found that it helps in these types of situations:

When feeling worried, stressed, or anxious -- counting slowly while breathing and concentrating on breathing for a minute or two can also help.
Before an important meeting, when feeling stage fright coming on, when you know you'll be in a stress situation, before starting an exam or participating in an athletic event, etc.
When having difficulty sleeping -- breathing deeply doesn't necessarily prevent insomnia, but it might help with relaxing the body so that it's more ready to fall sleep.
To calm children down, for example during "time out" or as part of the bedtime routine.
To enjoy a happy moment -- breathe for enjoyment!

Sometimes, simply paying attention to our breathing causes most people to slow it down and deepen it, which can result in positive effects. A good place to start is to actively breathe out completely and then allowing your lungs to refill themselves naturally (refilling through the nose if possible).

As with everything, don't overdo it -- moderation is best, and always use your good sense. If you have trouble breathing, call 9-1-1.

Did you know that scientists have found that yawning cools the brain? They have observed that animals with bigger brains yawn longer! A group of scientists observed 1,291 yawns across 55 mammal species and 46 bird species. Amongst their conclusions, they found that a typical mouse yawns for 0.8 seconds on average and that a human's yawn lasts for about 6.5 seconds.

References and Resources;

Scientific American on how proper breathing brings better health - https://www.scientificamerican.com/article/proper-breathing-brings-better-health/
Smithsonian Magazine on how breathing affects the brain - https://www.smithsonianmag.com/science-nature/how-does-breathing-affect-your-brain-180980950/
Mayo Clinic on breathing tips for kids - https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/tips-to-help-children-relax
NPR on study re breathing as an additive intervention for high blood pressure - https://www.npr.org/sections/health-shots/2022/09/20/1123500781/daily-breath-training-can-work-as-well-as-medicine-to-reduce-high-blood-pressure
PBS Kids on breathing exercises and tips to help calm young children - https://www.pbs.org/parents/thrive/breathing-exercises-to-help-calm-young-children
Canadian Broadcasting Corporation on breathing and meditation techniques - https://www.cbc.ca/life/wellness/from-fight-or-flight-to-rest-and-digest-how-to-reset-your-nervous-system-with-the-breath-1.4485695
Western Australia Healthy WA on calming techniques - https://www.healthywa.wa.gov.au/Articles/A_E/Calming-techniques-breathing-training
Wikipedia on prana - https://en.wikipedia.org/wiki/Prana
Cleveland Clinic on pursed lip breathing - https://my.clevelandclinic.org/health/treatments/9443-pursed-lip-breathing
Cleveland Clinic on diaphragmatic breathing - https://my.clevelandclinic.org/health/articles/9445-diaphragmatic-breathing
Johns Hopkins University on breathing exercises for coronavirus recovery - https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/coronavirus-recovery-breathing-exercises
Northwestern Medicine on 4 breathing techniques - https://www.nm.org/healthbeat/healthy-tips/4-breathing-techniques-for-better-health
Utrecht University on yawn study - https://www.uu.nl/en/news/the-longer-the-yawn-the-bigger-the-brain

Have you heard?

Tue, 28 Nov 2023 11:16:54 GMT

November 2023

The reality is that hearing loss can be uncomfortable, socially isolating, lead to cognitive decline, and and it can happen suddenly and at any age. We may to take our hearing for granted, but there are ways to proactively care for our ears before problems develop.

Exposure to noise

An obvious preventative measure is to limit our exposure to noise. For example, when listening to music, it is recommend to listen at no more than 50%-60% volume, and for less than an hour at a time. Similarly, if attending a loud concert, going out to a bar with live music, or using a leaf blower, taking 5 or 10 minute breaks away from the noise can help. Another option is to put on ear plugs that filter out extreme noise, or use noise-cancelling headsets that can block ambient noise.

The general rule of thumb is that prolonged exposure to above 85 decibels without protection can harm hearing. Surprisingly, some restaurants can register at 85 to 90 decibels, and depending on how close you are to fireworks, they can come in at 150 decibels! Ideally, being in environmenets below 70 decibels is best.

The National Institute for Occupational Safety and Health (NIOSH), part of the Centers for Disease Control and Prevention (CDC), developed the NIOSH Sound Level Meter (SLM) app (unfortunately, only for iPhones). It gives an indication of the decibel level around you, which is interesting and which is information you can act upon:

Ear wax is normal

For most people, the ear canals do a great job of cleaning themselves. Earwax, or cerumen, is a waxy oil produced by glands in our ear canals to trap dust, bacteria, and other small objects and prevent them from entering and damaging our ears. Earwax also collects the skin that's shed in the ear canals (our bodies constantly shed skin) and earwax normally makes its way out the ear naturally.

Some people may have issues with earwax if their ears produce too much, or if they have narrow ear canals, or the outer portion of the ear canal doesn't line up with the inner portion, preventing wax from coming out naturally. If you suspect an earwax problem, it is recommended to consult with your GP to learn the best earwax removal method for your particular situation.

It's ok to get our ears wet and occasionally accidentally get water in our ears. Leaning our head to one side and shaking the outer ear or hopping on that side's foot may help remove the water. It is not recommended to stick cotton swabs in our ears due to the risk of damaging the sensitive skin in the ear canal or the eardrum. Simply using a finger wrapped in tissue should suffice.

Stress, allergies, upper respiratory infections, sinus infections, congestion

A build-up of stress can put more pressure on the nerves, come with excess body heat and increased blood flow. The extra pressure can affect the inner ear and can result in a ringing or buzzing sensation known as tinnitus.

An upper respiratory infection can cause fluid build-up and/or inflammation, which can lead to a fullness sensation in the ears, ear infection, hearing loss, and/or dizziness.

With allergies, a thickened posterior nasal drainage that goes by the eustachian tube on its way to the lower parts of the throat can cause a bit of inflammation or swelling at the origin of the eustachian tube and give the feeling of fullness or pressure.

The risk of hearing loss can be reduced by treating these conditions promptly.

Activities such as air travel, swimming

Swimming, for example, can cause water to get in ears and be bothersome, and a way to prevent this is to wear earplugs when in the water. It's worthwhile noting that an audiologist can make custom-fit molds for kids and adults. Also, try to avoid swimming in dirty water.

Quick changes in pressure between the inner ear and the outside environment can also cause discomfort, as with airplane travel. Swallowing helps to alleviate this and young children can be encouraged to swallow by using a pacifier. Older kids and adults can chew gum, yawn, suck on candy, etc., again to encourage swallowing.

Diseases, medications

Hearing loss can be caused by viral diseases including mumps, measles, pertussis (whooping cough), meningitis, syphilis, and rubella (German measles). These types of infections are more common in childhood, although adults who haven’t been immunized and didn’t have the diseases in childhood may catch them too.

Medications that are thought to cause hearing loss include medications for malaria (quinine and chloroquine) and salicylates like aspirin, but the hearing loss is believed to be temporary.

Diet

In general, antioxidants help to keep us healthy and they are good for our vascular health (blood vessels), which also helps keep our ears healthy. Thus having a diet that is rich in antioxidants and flavonoids helps to combat all types of inflammatory disease: drinking green tea, eating blueberries, having broccoli, pecans, dark leafy greens, etc.

Signs of hearing loss

Here are some warning signs:

Difficulty hearing conversations, especially in the presence of background noise.
Frequently asking others to repeat what they’ve said.
Not always understanding what other people are saying and answering inappropriately.
Having difficulty hearing on the telephone.
Nodding your head or smiling during conversations when you are not sure what has been said. Or having to strain to hear or keep up with conversations.

Additional warning signs include:

Requiring the television or radio volume to be louder than others in the room prefer.
Feeling that people are mumbling or have marbles in their mouth when they talk.
Having a hard time hearing environmental sounds, such as birds chirping.
Withdrawing from conversations and social situations because it’s too difficult to hear.
Reading lips so you can try to follow what people are saying.
Hearing noise within your ears or head, or ringing in your ears, which isn’t caused by an external sound source.

Talk with your GP about any of the above warning signs or if you have drainage, itching, or pain in your ears. The earlier any condition is diagnosed, the better!

Resources and References:

NIOSH sound meter app for iOS -- https://apps.apple.com/au/app/niosh-sound-level-meter/id1096545820
National Institutes of Health, Noisy Planet, Protect Their Hearing -- https://www.noisyplanet.nidcd.nih.gov/have-you-heard/cdc-niosh-app
Mt Sinai on earwax -- https://www.mountsinai.org/health-library/diseases-conditions/ear-wax
New England Health System on protecting hearing -- https://www.womenandinfants.org/blog/7-tips-for-protecting-your-hearing
American Speech-Language-Hearing Association on ear care tips -- https://www.asha.org/news/2023/asha-offers-tips-for-ear-care-and-hearing-protection-this-summer/
University Hospitals on how to take care of your hearing -- https://www.uhhospitals.org/blog/articles/2023/03/all-ears-how-to-take-care-of-your-hearing
University of Queensland on tips for keeping ears happy and healthy -- https://habs.uq.edu.au/blog/2023/03/8-tips-keeping-your-ears-happy-and-healthy
Victoria Department of Health on ways to protect your hearing -- https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/ears-ways-to-protect-your-hearing
Cleveland Clinic on ear care tips -- https://my.clevelandclinic.org/health/articles/13076-ear-care-tips
American Medical Association on what doctors wished patients knew about proper ear care -- https://www.ama-assn.org/delivering-care/public-health/what-doctors-wish-patients-knew-about-proper-ear-care
Stanford Medicine on the anatomy and physiology of the ear, including an overview of how we hear -- https://www.stanfordchildrens.org/en/topic/default?id=anatomy-and-physiology-of-the-ear-90-P02025

OTC medications

Mon, 30 Oct 2023 23:17:50 GMT

October 2023

Over-the-counter ("OTC") medicines, available without a prescription, help to combat a variety of conditions. For example: asthma, headaches, pain, upset stomach, colds, constipation, pain, etc. They help make us feel better and the notion of "danger" might not immediately come to mind when we take them, but it is prudent to remember that they contain active and inactive ingredients that can lead to adverse consequences.

We'd like to bring your attention to several common circumstances when extra care should be taken to reduce risks. Best practice is to keep an updated list of prescription medications, supplements, natural and herbal supplements, and to share that list with your doctor and pharmacist, especially when you're considering starting on an OTC drug.

Overdosing

OTC medicines contain multiple active ingredients used to treat a variety of symptoms, so it is easy to inadvertently take too much, especially when mixing and matching products. As well, some cold and allergy medicines contain common ingredients, which can again lead to unintentionally overdosing.

To add to the problem, symptoms of taking too much acetaminophen, for example, can take days to appear and they can mimic cold or flu symptoms, making it difficult to diagnose the underlying cause. Toxic levels of acetaminophen (which can cause liver failure) could result by taking too much Tylenol and Theraflu at the same time, for example, as they both contain acetaminophen.

Be careful not to take more than the recommended dosage of a drug or supplement not only in one single product, but also when using multiple products for multiple symptoms.

Drug interactions

OTC medications can interfere with prescription medications by:

having similar active ingredients and therefore causing you to take more medicine than needed. For example, taking Advil while also taking a prescription anti-inflammatory can lead to liver or kidney damage.
making the prescription medication less effective or cancelling it out. For example, a decongestant such as Sudafed can raise blood pressure, reducing the effectiveness of blood pressure medication.
change the way prescription medication works. For example, aspirin can cause thinning of the blood, leading to an additive effect with blood thinners.

These are just a few examples of drug interactions. Each situation is very specific (health condition, illnesses, age, etc.) and you are encouraged to talk with your doctor or pharmacist about your or your loved one's specific situation.

Drug/food interactions

Following recommendations about taking medications on a full or empty stomach can make the difference between having nausea and having the medication be absorbed properly by your body.

Certain foods can interfere with the way a medication works. For example, grapefruit juice or grapefruit can interfere with cholesterol reducing medications. Herbal supplements can also affect the way certain prescription medications work.

Sometimes it's the combined effect of age and certain prescription drugs that can affect a person's ability to absorb important nutrients from food. In such situations, a doctor or pharmacist should be consulted for supplement recommendations.

Ask your doctor or pharmacist if any foods are not recommended for your personal situation, given any prescription and/or OTC medications or supplements you take.

Addiction

OTC medicines are meant for short-term relief and their labels usually indicate the maximum number of days they can be taken safely. Respecting the guidelines will reduce the chances of certain forms of mild addiction.

For example, taking Excedrin for migraine over an extended time can cause rebound headaches. Or decongestant nose sprays, for example, can lose their effectiveness over time, requiring a higher dose to get the same relief. Prolonged use of certain laxatives, for example, can lead to severe dehydration, internal organ damage, irritable bowel syndrome, and liver damage.

If you find that you need an OTC medicine for longer than the recommended time, consult with your doctor to reassess the situation before taking more than the recommended dosage.

Bottom line

Each person's situation is different, not only because of any prescription or OTC medications they use, but also due to many factors such as: current and past illnesses, family history, supplements used, alcohol intake, age, pregnancy, etc.

To minimize risk and avoid potentially serious, irreversible health problems, make sure that each of your doctors, specialists, and pharmacists are updated about what you take. This provides valuable information for them to better advise you about your health.

✧ This blog post is dedicated to Dot. ✧

Left-Handedness

Sat, 30 Sep 2023 22:16:46 GMT

September 2023

Being a left-handed person has never been easy. The stigmatism of having a left dominant hand is even anchored in human language.

The word "left" in Italian is "sinistra", a word from the 15th century with roots going back to the Latin "sinister". It was used in the sense of "dishonest, unlucky, unfavorable", and left-handed people were accused of practicing witchcraft. We may have heard people being described as "gauche", or "left" in French, to refer to their awkwardness. The term "southpaw" is occasionally used endearingly to refer to a left-handed person, although it is sometimes considered stigmatizing.

As far as daily life, we can all imagine (or experience) the difficulty of using one's left hand to turn the knob of a regular manual can opener. Or reading the upside-down numbers on a tape measure. Or doing one's best to squeeze pruning shears in a way that would make them work. Or constantly smudging the ink with one's hypothenar while writing (that's the fleshy part of the palm at the base of the little finger). Or raising a left-handed child as a right-handed person. Or holding one's cards for a bridge game. And the list goes on...

It could be argued that left-handed people, because of having to adjust to a right-handed world, may have learned more skills than right-handed people: resilience, adaptability, resourcefulness, etc. Some left-handed people are so successful at training themselves to use their right hand that they could be considered close to being ambidextrous.

It is currently still difficult to determine the exact percentage of the human population that is either. Estimates are that between 10% and 18% of humans are left-handed, but the measurement scale commonly used to assess hand dominance, the Edinburgh Handedness Inventory (EHI), developed in 1971, contains questions that may be outdated or irrelevant. For example, the original EHI assessed the hand used to light a match. Add to that the difficulty for accounting for the ability of some left-handed people to be able to use their right hand as the dominant hand for certain activities. And the tradition of forcing young left-handers to use their right hand, and we can see why it's difficult to arrive at an accurate percentage.

It is hypothesized that left-handed people who play interactive sports (tennis, baseball, martial arts, fencing, etc.) may have an advantage because right-handed opponents don't expect left-handed moves. However, such an advantage would diminish as the person rises to the top of their sport and competes against other left-handed people who might have risen in the same way.

Other myths, though persistent, have been studied and refuted. Examples include:

Left-handed people are not necessarily diagnosed with a large number of diseases, from autoimmune disease to psychiatric disorders.
Left-handed people do not die seven or nine years younger than right-handed people.
Left-handed people aren't more likely to stammer than right-handed people.

What causes left-handedness?

Scientists have speculated on a number of causes (examples include birth complications, the use of ultrasound during pregnancy, high levels of testosterone in the foetus, etc.) but none have been proven to be the cause. However, observations of which thumb a second- or third-trimester foetus sucks on predicts whether the child will be left- or right-handed, so scientists postulate that handedness is likely set before birth, possibly by the brain or by our genes.

To date, scientists have been unable to find a simplified theory that works. It was postulated that the left side of the brain controls both language processing and writing with the right hand because it is more efficient (same side of the brain). But brain hemisphere activity as shown on magnetic resonance imaging (MRI) has disproved that theory, when it could be seen that most left-handed people also process language with the left side of their brain.

Similarly, with DNA (gene) studies, scientists have found at least 41 spots in DNA that are associated with handedness. It turns out that handedness, like asthma and height, is a polygenic trait, which means that many genes each make a small contribution.

The research continues as it doesn't seem that there is a single cause for handedness.

What about the animal world?

It is interesting that while studying lateralization (the idea of asymmetrical brain function, that the two sides of the brain do not do the same things) in dolphins, some scientists discovered that it was necessary to go back to basics and better define body movement. (See the Scientific American link in the References list below.)

To get a feel for needing a better definition, try the following:

1. Stand up and spin "right".

2. Lie down, face-down on the floor and roll "right".

For the upright case, most people would turn so that their right shoulder moved towards their back. While lying down, most people would turn so that their right shoulder would move towards their chest. Thus, most people would make the exact opposite rotation!

The scientists who observed this because they couldn't come to agreement on this point came up with a system inspired by the "right-hand rule" of electromagnetism. According to that rule, if you point your right thumb in the direction in which an electric current flows through a wire (A above), the curve of your fingers shows you the direction of the magnetic field flowing around that wire (B above).

They adopted the general outline of this schematic model to create the right-fingered spin (RiFS) versus the left-fingered spin (LeFS) coding system. Thus, when the researcher's thumb is oriented along the animal's long axis, pointed toward its head, the curled fingers of the relevant hand describe the direction of the rotation.

There haven't been any definitive conclusions with animal handedness studies, but it's fascinating that scientific progress can be made in so many different ways -- sometimes it's a new discovery and sometimes it's a new way of looking at the same thing!

References and Resources:

Online Etymology Dictionary - https://www.etymonline.com/word/sinister
Time magazine on how lefties first gained acceptance - https://time.com/3978951/lefties-history/
McGill University on science and left-handedness - https://www.mcgill.ca/oss/article/health-general-science/are-you-left-handed-science-still-yearns-know-why
Victoria, Australia government on left-handedness - https://www.betterhealth.vic.gov.au/health/healthyliving/left-handedness#the-development-of-preferred-handedness

Scientific Reports on A large-scale population study of early life factors influencing left-handedness - https://www.nature.com/articles/s41598-018-37423-8

National Library of Medicine - Understanding Left-Handedness - on the current state of knowledge concerning the development of motor lateralization with reference to left-handedness - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3258574/

National Library of Medicine - Is handedness related to health status? - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3345498/
Scientific American - Are dolphins right-handed or left-handed? - https://www.scientificamerican.com/article/are-dolphins-right-handed-or-left-handed/

Get to know Constanza -- Conocer a Constanza

Mon, 28 Aug 2023 00:02:14 GMT

agosto 2023 / August 2023

Did you know that Constanza was the Pharmacy Technician on duty when Brittany, our head pharmacist, had her very first shift on her own as a young pharmacist? Constanza’s career took several turns before arriving at The Pharmacy at Wellington as a Pharm.D. and that path says a lot about Constanza’s determined, assiduous, and caring personality.

As a first-generation immigrant from Colombia, Constanza has always believed in having a back-up plan. She has always held several jobs at a time, even while studying. During her first career as a science teacher, she also worked as a Pharmacy Technician. She loved learning about drugs and chemistry and the next natural step was to obtain her Pharm.D..

This would not be an easy feat for anyone, but Constanza reached her goal while working two jobs and raising two kids with her husband. She is the master scheduler! And she lives every moment to the fullest. (...more in English below...)

¿Sabías que Constanza era la técnica de farmacia de turno cuando Brittany, nuestra farmacéutica jefa, tuvo su primer turno sola como joven farmacéutica? La carrera de Constanza dio varios giros antes de llegar a "The Pharmacy at Wellington" como "Pharm.D." y ese camino dice mucho de la personalidad decidida, asidua y solidaria de Constanza.

Como inmigrante de primera generación de Colombia, Constanza siempre ha creído en tener un plan de respaldo. Siempre ha tenido varios trabajos a la vez, incluso mientras estudiaba. Durante su primera carrera como profesora de ciencias, también se desempeñó como Técnica de Farmacia. Le encantaba aprender sobre drogas y química y el siguiente paso natural fue obtener su Doctorado "Pharm.D.".

Esto no sería una hazaña fácil para nadie, pero Constanza alcanzó su objetivo mientras trabajaba en dos trabajos y criaba a dos hijos con su esposo. ¡Ella es la programadora maestra! Y ella vive cada momento al máximo.

Si tuvieras un superpoder, ¿cuál sería?

Sin dudarlo, Constanza elige “¡poder hacer todo más rápido! ¡No hay suficiente tiempo en el día!

Constanza disfruta ir de campamento con su familia, descubrir diferentes áreas de Arkansas, ya que le da la oportunidad de pasar tiempo de calidad con la familia. Le gusta trotar para hacer ejercicio y participó (con su hijo y un grupo de colegas) en la carrera "Dam Night Run" de 5 km en Arkadelphia en julio pasado.

Su género musical favorito es el reggaetón, que es una mezcla latinoamericana de rap, hip hop, reggae, etc. Un ejemplo es "Greeicy" de Dana Paola. A Constanza también le gusta leer novelas de misterio para relajarse... ¡y agradece sugerencias de títulos!

If you had a superpower, what would it be?

Without hesitation, Constanza chooses “being able to do everything faster! There’s not enough time in the day!”

Constanza enjoys going camping with her family, discovering different areas of Arkansas, as it gives her the chance to spend quality time with family. She likes to jog for exercise and participated (with her son and a group of colleagues) in the 5 km Dam Night Run in Arkadelphia in July.

Her favorite genre of music is Reggaeton, which is a Latin American mix of rap, hip hop, reggae, etc. An example is Dana Paola’s "Greeicy". Constanza also likes to read murder mysteries to relax … and she welcomes suggestions for titles!

What do you think is the best human invention/discovery so far?

Electricity – I couldn’t live without it. I need A/C, heat, power for the TV and the camper, and of course, for the internet!

¿Cuál crees que es el mejor invento/descubrimiento humano hasta ahora?

Electricidad: no podría vivir sin ella. Necesito aire acondicionado, calefacción, electricidad para la televisión y la caravana y, por supuesto, ¡para Internet!

What is a common misconception about your profession?

Two come to mind:

Pharmacists only check prescriptions and don’t do anything else. Here are a couple of links to our other blog pages which give insight into what we do:
https://www.thepharmacyatwellington.com/get-to-know-us
https://www.thepharmacyatwellington.com/we-re-here-to-help
https://www.thepharmacyatwellington.com/what-do-people-ask-us-pharmacists
Pharmacists know everything medical-related. I have been asked to read and interpret an MRI!

Well, there’s no misconception about Constanza being a caring colleague and pharmacist. We’re so happy she’s part of our team at The Pharmacy at Wellington!

¿Cuál es un error común acerca de su profesión?

Me vienen a la mente dos:

Los farmacéuticos sólo revisan las fórmulas médicas y no hacen nada más. Aquí hay un par de enlaces a nuestras otras páginas de blog que dan información sobre lo que hacemos:
https://www.thepharmacyatwellington.com/get-to-know-us
https://www.thepharmacyatwellington.com/we-re-here-to-help
https://www.thepharmacyatwellington.com/what-do-people-ask-us-pharmacists
Los farmacéuticos saben todo lo relacionado con la medicina. ¡Ya me han pedido que lea e interprete una resonancia magnética!

Bueno, no hay una idea errónea de que Constanza es una colega y farmacéutica empátetica. ¡Estamos muy contentos de que sea parte de nuestro equipo en The Pharmacy at Wellington!

Recognizing Heat Illnesses

Thu, 27 Jul 2023 00:45:03 GMT

July 2023

Our bodies are quite good at adapting to various external conditions. When it’s hot, we regulate our temperature by sweating. The small water droplets at the surface of our skin use heat from our skin to evaporate, thus cooling us down. Under certain conditions, the maximum sweat rate of an adult can be up to 2 to 4 quarts per hour. To note, if there is high humidity in the air, our sweat doesn’t evaporate as quickly, which means that we don’t feel as much of a cooling effect.

We have all heard of the importance of replenishing our electrolytes, lost in the sweating process. Our cells use electrolytes to conduct electrical charges, which is how our muscles contract. Electrical charges also control chemical reactions in our cells. As well, the neurons in our brain use electrical events to communicate with each other. Keeping our electrolyte levels up is important!

It’s always good to know what signs to watch out for when too much heat is just too much. We hope that the descriptions below, of illnesses associated with heat (hyperthermia) will be helpful:

Heat Rash

Excessive sweating during hot, humid weather can cause the skin to get irritated.

Symptoms

Red clusters of pimples or small blisters appear, usually on the neck, upper chest, groin, under the breasts, and in elbow creases.

First Aid

Keep the rash area dry, applying powder to increase comfort. Don’t use ointments or creams.
Seek shelter in a cooler, less humid environment.

Heat Cramps

A person can get heat cramps when working or exercising (i.e. carrying out strenuous activity) that causes them to sweat a lot in a hot environment. The sweating depletes the body’s salt levels and, combined with drinking lots of water, the body’s electrolytes (nutrients) are diluted, causing painful cramps in muscles. Heat cramps may also be a symptom of heat exhaustion (see below).

At higher risk of heat cramps are: athletes, people who work outdoors, people in the military, etc.

Symptoms

Muscle cramps, pain, or spasms in:
Abdomen (belly)
Arms or hands
Legs or feet
Rib cage
Shoulders
Body temperature may be normal.

First Aid

Drink water and have a snack (such as a banana or a granola bar) or a drink (such as a sports drink) that replaces carbohydrates and electrolytes.
Avoid salt tablets.
Get medical help if the person has heart problems, has a low sodium diet, or has cramps that do not subside within 1 hour.

Heat Syncope (Fainting)

Fainting or getting dizzy when standing for too long or when suddenly standing up after sitting or lying down. Not acclimatizing and/or dehydration can contribute to heat syncope.

Symptoms

Fainting (short duration)
Dizziness
Light-headedness from suddenly rising or from standing too long

First Aid

Sit or lie down in a cool place.
Slowly drink water, clear juice, or a sports drink.

Rhabdomyolysis

Also known as rhabdo, it is a medical condition associated with heat stress and prolonged physical exertion. Rhabdo causes the rapid breakdown, rupture, and death of a muscle. When muscle tissue dies, electrolytes and large proteins are released into the bloodstream, possibly causing irregular heart rhythms, seizures, and/or damage to the kidneys.

Symptoms

Muscle cramps / pain
Abnormally dark (tea or cola-colored) urine
Weakness
Exercise intolerance
A person can also be asymptomatic.

First Aid

Stop activity.
Drink more liquids (water preferred).
Seek immediate care at the nearest medical facility.
Ask to be checked for rhabdomyolysis (i.e., blood sample analyzed for creatine kinase).

Heat Exhaustion

When the body sweats, it loses not only water but also salts and nutrients. People most likely to be affected by heat exhaustion are older folks, people with high blood pressure, and people who work in a hot environment.

Symptoms

Headache
Nausea
Dizziness
Weakness
Irritability
Thirst
Heavy sweating
Elevated body temperature
Decreased urine output

First Aid

Take the person to an urgent care clinic or call 911.
Stay with the person until a medical professional is present.
Give the person cool water to drink. Encourage frequent sips.
Remove unnecessary clothing, including shoes and socks.
Cool the person with cold compresses or have the person wash their head, face, and neck with cold water.

Heatstroke

Heatstroke is a life-threatening emergency condition. The body can no longer control its temperature, which rises rapidly, for example to 106°F or higher within 10 to 15 minutes, and the sweating mechanism fails. Heat stroke can cause permanent disability (brain damage, organ failure, etc.) or death if the person does not receive emergency treatment.

Symptoms

Confusion, altered mental status, slurred speech
Loss of consciousness (coma)
Hot and dry skin, profuse sweating, or clammy skin
Headache
Seizures
Visual problems
Very high body temperature
Rapid / shallow breathing
Low blood pressure
Increased heart rate
Fatal if treatment delayed

Take immediate action:

Call 911.
Stay with the person until ambulance arrives. If you are the patient, make sure you are with someone who can help.
Move the person to a shaded, cool area and remove outer clothing.
Cool the person quickly, using the following methods:
With a cold water or ice bath, if possible
Wet the skin
Place cold, wet cloths on the skin
Soak clothing with cool water
Circulate the air around the person to speed cooling.
Place cold, wet cloths or ice on the head, neck, armpits, and groin; or soak the person’s clothing with cool water.

Finally, here are some tips for avoiding hyperthermia altogether:

Take frequent breaks from the heat and go into air conditioning where possible. Give your body a chance to cool down.
Stay out of the heat and replenish the nutrients (electrolytes) lost from sweating.
Avoid beverages that contain caffeine such as energy drinks. Avoid alcohol which can affect your body’s ability to regulate its temperature. Stay well-hydrated with water.
People who have experienced heat-related illness in the past are at higher risk of doing so again, so take precautions. People who are not physically fit also run a higher risk.
Time outdoor workouts to avoid the hottest part of the day.
Some medications affect the body’s ability to stay hydrated and respond to heat. People who take medications that narrow the blood vessels (vasoconstrictors), that regulate blood pressure by blocking adrenaline (beta blockers), that rid the body of sodium and water (diuretics) or that reduce psychiatric symptoms (antidepressants or antipsychotics) should take extra precautions when it’s hot outside.
Get acclimated. Give your body time (one to two weeks) to get used to working or exercising in higher temperatures.

Stay cool! ��

Resources and References:

The Centers for Disease Control (CDC) on heat-related illnesses - https://www.cdc.gov/niosh/topics/heatstress/heatrelillness.html
Wikipedia on perspiration - https://en.wikipedia.org/wiki/Perspiration
Chicago weather channel on evaporation - https://wgntv.com/weather/weather-blog/why-does-wet-skin-always-feel-cold-but-dry-skin-doesnt/
Texas Education Agency on evaporation rates - https://www.texasgateway.org/resource/136-humidity-evaporation-and-boiling
Cleveland Clinic on heat cramps - https://my.clevelandclinic.org/health/diseases/24866-heat-cramps
Cleveland Clinic on electrolytes - https://my.clevelandclinic.org/health/diagnostics/21790-electrolytes
University of Queensland on neurons - https://qbi.uq.edu.au/brain-basics/brain/brain-physiology/action-potentials-and-synapses
The Mayo Clinic on heat and exercise - https://newsnetwork.mayoclinic.org/discussion/heat-and-exercise-keeping-cool-in-hot-weather/
The Mayo Clinic on heatstroke - https://www.mayoclinic.org/diseases-conditions/heat-stroke/symptoms-causes/syc-20353581
Johns Hopkins on dehydration and heat stroke - https://www.hopkinsmedicine.org/health/conditions-and-diseases/dehydration-and-heat-stroke
NPR on 8 mistakes to avoid if you’re going out in the heat - https://www.npr.org/sections/health-shots/2023/07/12/1187025949/heatstroke-heat-exhaustion-symptoms-prevent?utm_source=npr_newsletter&utm_medium=email&utm_content=20230716&utm_term=8754392&utm_campaign=health&utm_id=65140263&orgid=199&utm_att1=

Did my child have a concussion?

Thu, 29 Jun 2023 23:01:51 GMT

June 2023

Every once in a while, alarming news reports about concussions appear, as do opinions of people who brush off the effects of concussions. This can leave parents unsure of what guidelines to follow for their child, especially parents of kids who play soccer, football, wrestling, basketball, spend time at the playground, or other activities where there is risk of head injury (or falls causing head injury). In this blog, we aim to provide some information to help parents identify concussion symptoms and understand post-concussion care.

What is a concussion?

A concussion is a traumatic brain injury that affects brain function. Traumatic brain injuries can be mild, moderate, or severe, and they are usually caused by a sudden blow or impact to the head. Concussions can also be caused by a hit to the body or shaking the body strongly enough to cause the head to forcefully jerk backwards, forwards, or to the side. A person does not need to lose consciousness to have a concussion, and it can happen to a person of any age.

Our soft and squishy brain tissue is surrounded by cerebrospinal fluid, which acts as a cushion against the hard, protective exterior, the skull. When a sudden movement of the head occurs, it can make the brain bounce in the skull, stretching and bruising nerves and blood vessels, causing chemical changes in the brain that result in a temporary loss of normal brain function. A single concussion usually doesn't cause permanent damage, but multiple concussions may result in structural changes to the brain.

Concussions are more likely to occur in:

Kids 4 and under and older people, due to their risk of falls;
Kids and adolescents due to bicycle accidents and sports-related head injuries;
Military personnel due to exposure to explosive devices;
Anyone involved in a car accident;
Victims of physical abuse; and
Anyone who has had a previous concussion.

Symptoms of a concussion

Proper diagnosis and treatment are essential to a quick recovery after a brain injury. Concussion symptoms usually appear within minutes of the head injury, although some symptoms may take several hours to appear. For some people, symptoms can change days later, while for others, symptoms can develop when the brain is stressed with use.

Seek medical attention as soon as possible if a concussion is suspected. (This is so important that we repeat it below.) Consult with the sports team's physician, go to an emergency room, make an appointment with a general practitioner or pediatrician.

Common symptoms of concussion include:

Headache (this is the most common), one that gets worse, lasts for a long time, or is severe;
Nausea or vomiting;
Clear, watery discharge or blood draining from the nose or ears;
Confusion, such as difficulty recognizing people or places;
Weakness, numbness, or trouble walking or talking;
Balance problems, dizziness, lightheadedness;
Double or blurry vision;
Eye strain or the inability to open eyes on one's own;
Unusually sized-pupils (dilated pupils or pupils of unequal sizes);
Seizures or convulsions;
Persistent ringing in the ears;
Sensitivity to light and noise;
Vertigo;
Weakness in the arms or legs;
Disorders of taste and smell;
Slurred speech or other changes in speech;
Feeling tired or drowsy;
Changes in sleep patterns (sleeping much more or less than usual or can't sleep);
Trouble understanding, paying attention, and/or concentrating;
Depression or sadness;
Being irritable, grouchy, nervous, or anxious;
Feeling "just not right" or in a "fog";
Forgetfulness, memory loss;
Temporary loss of consciousness.

If you suspect that someone has had a concussion, additional signs to watch for include:

Bumps on the head, swelling of the soft spot, bruising (especially around the eyes or behind the ears);
Pale appearance for longer than an hour;
Obvious difficulty with mental function or physical co-ordination;
Will not eat or nurse;
Excessive crying;
Lack of interest in favorite toys;
More fussy than usual;
Blank stare; and
Listlessness and tiring easily.

It is rare, but a concussion can lead to bleeding in the brain or brain swelling that can be fatal. This is one of the reasons why it's important to carefully watch a concussed person in the first 24 to 48 hours after the concussion and to seek immediate care if symptoms worsen.

What to do after a concussion

It is important to stop the physical activity (where it's not caused by an accident).

Seek medical attention immediately.

Depending on the severity of the concussion and the specific situation, most concussion symptoms resolve within 14 to 21 days, but an undiagnosed, unrecognized, or poorly treated concussion can delay recovery to months or longer.

Since different areas of the brain control different functions, the location of the blow to the head can predict symptoms. A concussion on the back of the brain (i.e. a force at the front of the head causing the brain tissue to hit the back of the skull) can cause balance issues, fogginess, neck pain, and difficulty concentrating. These symptoms usually require a longer recovery time.

A physician may order a CT scan or MRI if more serious effects of a concussion are suspected, for example, bleeding inside the skull, brain swelling, or spinal cord or cervical spine injury, or if symptoms worsen. For kids in sports with concussion risk, there are also neuropsychological tests that can be used (ImPACT and others). An initial baseline assessment is done at the start of the season and another assessment is done post-concussion to help determine the student athlete's ability to go back to school and sport.

Physical and mental rest is necessary to recover from a concussion. Instead of stopping activities entirely, it is now recommended to start back slowly and add more activities into the day as symptoms improve. To help recognize the triggers that bring on concussion symptoms, here are some activities that bring on symptoms:

Texting or spending time looking at a smartphone screen;
Reading;
Watching TV;
Playing video games;
Listening to loud music;
Doing any physical activity.

Some medications mask symptoms and thin the blood, which may increase the risk of bleeding, so aspirin and nonsteroidal anti-inflammatory drugs (NSAIDS) such as naproxen (Aleve®) and ibuprofen (Advil®, Motrin®) should not be taken soon after a suspected concussion has occurred. This is of special concern for older individuals who may already be taking these drugs and then fall and hit their head. If pain medication is needed after a concussion is diagnosed, acetaminophen (Tylenol®) is a safer option. Symptoms need to be monitored closely.

Since diet affects brain health, it is recommended to continue a well-balanced diet, high in fruits and vegetables, low in saturated fat and processed foods, and with sufficient hydration. One thing to consider is that a concussed person may not feel as hungry or thirsty as before, so they may need encouragement to keep their blood sugar up and their body hydrated (see more on how much water is needed every day on our blog about it here ). The brain is sensitive to low blood sugar and dehydration and these conditions can mimic or worsen concussion symptoms such as headache, dizziness, fogginess, stomach ache, and irritability.

Adults with a concussion should refrain from drinking alcohol as it may slow recovery and increase the chance of further injury. Since reaction time can be slower after a concussion, it is recommended to refrain from driving until cleared by one's doctor.

To note, the idea that someone with a concussion should be woken from sleep at regular intervals is outdated information and is now considered a myth. However, it is reasonable to check on a concussed person who is sleeping to ensure that their breathing is steady and to ask them from time to time about their symptoms to ensure that they are not getting worse.

It may also be helpful to note down the day and time of events, medications, sleep, and symptoms as the volume of information will increase quickly and being able to refer back to a previous moment or symptom can be useful.

Recovery timelines and recovery plans from physicians are specific to each person and may involve:

Additional test or assignment time for students;
Extra breaks during the work day for an adult;
Avoiding crowds if the concussed person has balance problems;
Additional sleep as it can help the brain to heal itself;
Etc.

Concussed individuals, especially student athletes, should follow their medical professional's advice about returning to partial or full physical and mental activity, based on the results of their post-recovery assessments. If a concussed person returns to play or competition too soon and gets a second concussion, concussion symptoms can last longer, overall recovery can be delayed, and chances for long-lasting or permanent problems can be increased.

Are there long-term effects of a concussion?

Yes, and they include:

Post-concussion syndrome - where an individual experiences concussion symptoms for weeks or months after the concussion.
Higher risk of anxiety and depression, especially if there has been multiple concussions.
Structural brain injuries from multiple concussions, causing long-lasting impairment.
Problems with memory, naming, and word-finding.
Dementia.

Again, it is vital to seek medical attention if symptoms worsen or don't go away.

How to prevent a concussion

The following general safety guidelines can help to reduce the risk of concussion:

Wear seatbelts and buckle up kids in safety seats in your vehicle;
Wear a helmet when bicycling, motorcycling, horseback riding, or skiing;
Use handrails when going up and down stairs;
Install temporary safety gates in the home to protect young children;
Put nonslip mats in the bathtub and on floors
Remove trip hazards;
Consider playing sports that have lower risk of concussion; and
Strengthen neck muscles as they may be able to help some of the impact of blows to the head.

As pharmacist parents, we want to protect kids and adults, so we are positive on prevention!

Resources and References:

Mayo Clinic on concussions - https://www.mayoclinic.org/diseases-conditions/concussion/symptoms-causes/syc-20355594
CDC on concussion signs and symptoms - https://www.cdc.gov/headsup/basics/concussion_symptoms.html
Cleveland Clinic on concussions - https://my.clevelandclinic.org/health/diseases/15038-concussion
UC Davis health on spotting concussions - https://health.ucdavis.edu/blog/cultivating-health/how-to-spot-a-concussion-and-what-to-do-if-you-suspect-a-brain-injury/2022/09
Medical Xpress on link between sleep and concussion - https://medicalxpress.com/news/2023-06-link-concussion.html
BBC News on whether ban on heading the ball has affected soccer in the USA - https://www.bbc.com/news/uk-scotland-51618401
Health Direct on concussions - https://www.healthdirect.gov.au/concussion

Iron in our bodies

Wed, 31 May 2023 17:33:16 GMT

May 2023

What does the human body do with iron (Fe*), which is by mass the most common element on Earth?

Our bodies use iron in transporting oxygen by blood and in storing oxygen in muscles, but we don't need much of it. An adult male body of 165 to 180 lbs contains about 0.14 oz of iron. We get the small amount of iron that we need from food because our bodies can't produce it.

Iron is absorbed by the small intestine and transferred into the blood. Interestingly, the body self-regulates iron levels, increasing absorption when there is a deficiency and decreasing it when there is too much. In mammals, there is no pathway to rid the body of excess iron, so iron levels are regulated at the point of absorption. As you might guess, too little or too much iron is not good for us.

In our bodies, iron is a major component of hemoglobin, a type of protein in red blood cells that carries oxygen from our lungs to all parts of our body. Without enough iron, insufficient oxygen is transported, leading to fatigue, one of the symptoms of iron-deficiency anemia. Iron is also part of myoglobin, a protein that carries and stores oxygen specifically in muscle tissues. Our bodies also use iron in brain development and growth for children and for the normal production and function of various cells and hormones.

Which foods contain iron? How about supplements?

There are two types of iron in foods:

heme iron - found in red meat, poultry, canned sardines and canned light tuna, organ meats, etc. This type is most easily absorbed by our body, at a rate of 15% to 35%.
non-heme iron - found in spinach, iron-fortified breakfast cereals, enriched rice or bread, beans, dried fruits, nuts and seeds, tofu, pumpkin seeds, dark chocolate (at least 45% cacao), potato with skin, etc.

While absorption of non-heme iron is only 2% to 20%, the presence of ascorbic acid (vitamin C) increases this absorption rate. Since the human body cannot produce vitamin C, we get it from food: orange and other citrus, red and green bell peppers, kale, broccoli, kiwi, grapefruit, pineapple, spinach, etc. There are also inhibitors of iron absorption, some of which contain non-heme iron, so the best way to ensure sufficient iron intake is to eat a healthy, varied, and balanced diet.

Some doctors also recommend iron supplements for certain individuals, and our pharmacists are happy to consult with you regarding the various types of iron supplements are the one most suited for your situation, especially if you take medications that can interact with iron. Please note that iron supplements need to be kept away from the reach of children as overdosing on iron can be lethal.

Can I increase my iron intake by cooking with cast iron cookware?

The conclusion from a 2021 systematic review of scientific literature suggests that there is some evidence that eating food prepared in iron pots increases the hemoglobin concentration of iron deficient individuals. This review was carried out in the context of finding inexpensive and effective ways to reduce iron deficiency in populations. In 2019, the prevalence of anemia was almost 30% globally.

How can I tell if I lack iron or have too much of it?

Humans typically lose small amounts of iron in urine, feces, the gastrointestinal tract, and skin. Losses are greater in women with periods because of blood loss, especially women with heavy menstruations. Pregnant women need a little more iron than non-pregnant women.

Donating blood also means blood loss, although donors should know that if their hemoglobin level is low, as tested by the pre-donation finger prick, they cannot donate blood. It's not a test of their iron level, but it can signal the need to assess for iron deficiency and/or make an appointment with a doctor. To note, where there is marginal iron deficiency, hemoglobin levels usually remain within the normal range even though iron stores are depleted.

Below are some symptoms to watch for, and the best approach is to talk with a healthcare professional if you have questions. Please feel free to drop by and talk with one of our pharmacists during our extended hours -- you don't need an appointment.

Some signs of lacking iron may include:

fatigue, weakness
lightheadedness
confusion, loss of concentration
sensitivity to cold
shortness of breath
rapid heartbeat
pale skin
hair loss, brittle nails
pica, which is craving non-food items like dirt, clay, ice, etc.

Some signs of having too much iron in the body may include:

constipation
upset stomach
nausea, vomiting
abdominal pain

Iron overload can also lead to other more serious health concerns, such as cirrhosis of the liver, diabetes, cancer, and death.

It is important to consult if you have any questions or concerns about having too little or too much iron for yourself, a child, or an older loved one.

* Iron is on the Periodic Table as Fe, which is from the Latin word for iron, 'ferrum'.

Resources and References:

Wikipedia on iron - https://en.wikipedia.org/wiki/Iron
National Library of Medicine (NIH) on iron and its importance for human health - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3999603/
Harvard School of Public Health on iron - https://www.hsph.harvard.edu/nutritionsource/iron/
Wikipedia on vitamin C sources - https://en.wikipedia.org/wiki/Vitamin_C
NIH on the interaction of vitamin C and iron - https://pubmed.ncbi.nlm.nih.gov/6940487/
NIH on the effect of cooking food in iron-containing cookware - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8266402/
NIH on intervention for reducing iron deficiency anemia - https://pubmed.ncbi.nlm.nih.gov/12859709/
World Health Organization on the prevalence of anemia in the world - https://www.who.int/data/gho/data/themes/topics/anaemia_in_women_and_children
American Red Cross on iron in the body - https://www.redcrossblood.org/local-homepage/news/article/iron-in-blood.html
NIH on iron - https://ods.od.nih.gov/factsheets/Iron-HealthProfessional/
National Health Service UK on iron - https://www.nhs.uk/conditions/vitamins-and-minerals/iron/
Mayo Clinic on iron-deficiency anemia - https://www.mayoclinic.org/diseases-conditions/iron-deficiency-anemia/symptoms-causes/syc-20355034

Neuroscientific tips for learning

Wed, 19 Apr 2023 02:53:25 GMT

April 2023

Learning strategies based on what science knows about the brain*

The nervous system has been studied since ancient Egypt, and it has only been since the 1900's that neuroscience became a distinct academic discipline. Today, what neuroscientists have learned about the brain can be applied to learning, and who wouldn't want to try to learn better and faster?

How the brain functions, an analogy

Let's say we want to get to a spot in the middle of the jungle. There's a lot of vegetation so we clear the way with a machete. If we want to go back the next day, the path is already cleared and it's easy to go back. If we don't go there for a year and then go back, we have to clear the way again because the vegetation has grown back.

Memory works in the same way. The paths are how neurons communicate (via synpases) and they allow us to easily access information that we've saved. The first communication between two neurons is weak and we have to maintain the path, or revisit the information, so that the path gets stronger. A path that is used often is easier to access. One that is not used often or not used for a long time takes more work to access.

If we cram before an exam, we might remember the material for the test, but it might be very difficult to access the material later, for example when it's needed for a subsequent level course.

What are some strategies?

Spaced repetition - This is where a concept is reviewed at regular intervals rather than reviewed multiple times in one sitting.

Interleaving - Switch back and forth between different learning techniques (such as self-testing, reading, explaining the concept, recalling, etc.) and between different topics. Pick up studying at different points of the material.

Pomodoro - Study and focus for 20-25 minutes, take a 5 minute break, study for 20-25 minutes, etc. This technique helps to build the ability to focus and relax.

Diffuse mode - Take a nap! Every so often, after intense study and in the focused mode, the brain needs some diffuse mode time and the ultimate diffuse mode is sleep. Taking a break, doing something relaxing, getting some physical exercise, etc. puts our brain in diffuse mode, when it consolidates the information. To note: naps don't replace studying, they're complimentary and used to solidify information.

Physical activity - There are neurotrophic factors called BDNF in the brain that promote the growth of neurons. Physical exercise produces BDNF in the brain and improves memory and neuron connections, thus helping with retaining learned material for the longer term.

Memory palace - Think of a familiar place and associate concepts with things in that place, so that you can remember those concepts more easily. A similar idea is to connect concepts with smells or tastes, using a mental map. If a certain scent (essential oil, perfume, cologne, etc.) is used during studying, use the same scent during the test.

Chunking - Associate a group of concepts together so that there are already connections between them. When the information is recalled, we can recall the whole chunk.

Space out learning - Over at least several days, to give time for the new synapses between neurons to form.

Eat your frogs first - Start the most difficult work first. You can either finish it or take a break and let your diffuse mode help you.

Lifelong learners

Each learner will need to find the strategies that work best for them because each individual is different. We hope that these tips might not only help the younger learners, but also the adult learners out there!

*While we're not experts in this area, we are lifelong learners ourselves. We're also fans of the Massive Open Online Course (MOOC) called Learning How to Learn, taught by Barbara Oakley. And we sincerely hope that some of these learning strategies will help students as they enter the final sprint to the end of the school year.

Resources and References:

Barbara Oakley, PhD on Learning How to Learn - https://barbaraoakley.com/
Barbara Oakley, PhD on 10 top ideas and 10 pitfalls - https://barbaraoakley.com/wp-content/uploads/2018/02/10-Top-Ideas-to-Help-Your-Learning-and-10-Pitfalls.pdf
Wikipedia on Brain-Derived Neurotrophic Factor - https://en.wikipedia.org/wiki/Brain-derived_neurotrophic_factor
Radio-Canada on learning better thanks to neuroscience - https://ici.radio-canada.ca/ohdio/premiere/emissions/les-annees-lumiere/segments/reportage/439426/apprendre-etudiants-mcgill-scilearn-programme-neuroscience-cerveau
McGill University Scilearn program - https://www.mcgill.ca/ose/initiatives/scilearn/scilearn-events
Wikipedia on neuroscience - https://en.wikipedia.org/wiki/Neuroscience

Am I losing too much hair?

Sat, 18 Mar 2023 14:06:33 GMT

March 2023

How does hair grow?

Should we be concerned about how much hair we're losing in the shower or when we run a brush or a comb through our hair? Let's look at how hair grows and some factors that contribute to hair loss to better understand when there might be cause for concern.

To start with, we are born with a set number of hair follicles (pores in our skin where hair roots grow) and our bodies don't create new hair follicles after birth. A person has about 5 million hair follicles and each one goes through the three stages of the hair growth cycle, which typically lasts between 2 to 6 years:

1. Anagen phase - this first phase is the active growth phase, during which a hair follicle provides blood supply and nutrients at the root. A hair strand grows at a rate of about 1 centimeter per month. This phase can last from 2 to 8 years and about 85% to 90% of the hair on our heads is in this phase. Shorter hairs like eyelashes, eyebrows, and arm and leg hair have a shorter anagen phase of about a month.

2. Catagen phase - during this transition phase of a few weeks, the hair follicle begins to shrink and detach from its blood supply. The hair stops growing, becomes "club-shaped" (where the bottom of the hair is thicker than the top), and prepares to enter the resting phase. Even though it's transitioning to the next phase, the hair doesn't usually fall out until a new hair has grown to push it out of the follicle. The catagen phase lasts about 4 to 6 weeks.

3. Telogen phase - about 10% to 15% of all hairs on the body are in this resting phase, during which the hair shaft doesn't grow further, but a new hair starts to grow under the shaft. Depending on the location of the hair, this phase can last from a few weeks, for eyelashes, to almost a year, for hair on our scalp. An extension of the telogen phase is the exogen phase, the shedding stage when the old hair completely detaches and falls out. The average person loses about 50 to 100 strands of hair per day, usually while washing their hair or combing or brushing it.

The exact mechanism that controls passage from one phase to the next is not fully known. Hair strands are in a different cycle at the same time and hair growth cycles vary between people depending on age, genetics, diet, environmental factors, stress, etc. Also, overall hair density slowly decreases with age.

What are some common causes of hair loss?

Sometimes the random cycle of hair growth becomes synchronized, resulting in a temporary hair loss called telogen effluvium. This is a sudden onset, generally occurring within three months following situations such as: childbirth, rapid weight loss, surgery, death of a family member, etc. Thyroid conditions and medications can also cause hair loss due to abnormal cycling. This type of hair loss tends to resolve itself after several months, although that may not always be the case.

Genetic hair shedding, known as androgenetic alopecia, can be inherited from either side of the family and affects both men and women. This is the most common type of hair loss and is also known as "pattern" hair loss.

Traction alopecia is where repeated pulling of hair, for example with tight pony tails or braids, results in hair loss. At first, the hair may grow back, but persistent damaging activity can make the loss permanent.

Temporary or permanent hair loss can also be caused by:

reactions to certain drugs (for example, chemotherapy)
fungal infections
inflammation
autoimmune disease
having had high fever
having stopped taking birth control pills
menopause
harsh hair care products
the compulsion to pull out one's hair

If you're concerned about the volume of hair lost every day, have sudden bald patches, or other hair loss concerns, consult your doctor or dermatologist. Dermatologists can distinguish between hair loss and normal hair shedding as they specialize in diagnosing and treating the skin, hair, and nails. As with most medical conditions, the sooner you see a professional, the better the prognosis.

Interested in helping people who have lost their hair?

Besides keeping our head, ears, and neck warm, the hair on our heads is one of the first things we notice about someone. Losing it can mean a certain loss of self-confidence, so replacing it can help to re-establish overall well-being, especially when a person is fighting a disease at the same time.

There are quite a few options for donating hair to be used for making wigs. A quick internet search will show which companies and non-profits accept hair, their focus (for example, kids with cancer), what they accept (for example, curly or wavy hair, gray hair, etc.), the minimum length, and the condition and format that the donated hair must be in to be useful.

Donating hair for a cause that best matches your objectives will be most rewarding.

Resources and References:

Mayo Clinic on symptoms of hair loss - https://www.mayoclinic.org/diseases-conditions/hair-loss/symptoms-causes/syc-20372926
Cleveland Clinic on hair follicles - https://my.clevelandclinic.org/health/body/23435-hair-follicle
Cleveland Clinic on hair loss facts and myths - https://my.clevelandclinic.org/health/diseases/16921-hair-loss-in-women
Stages of hair growth - https://www.rosemaryhealth.com.au/guides/stages-of-hair-growth
American Hair Research Society with descriptions of hair disorders and photos of types of hair loss - https://americanhairresearchsociety.org/patient-information/
American Hair Research Society on the difference between hair loss and hair shedding - https://www.aad.org/public/diseases/hair-loss/insider/shedding
Harvard Health on hair loss - https://www.health.harvard.edu/a_to_z/hair-loss-a-to-z
NHS on causes and treatments for hair loss - https://www.nhs.uk/conditions/hair-loss/
National Library of Medicine on hair physiology - https://www.ncbi.nlm.nih.gov/books/NBK499948/
Forbes article on hair loss - https://www.forbes.com/sites/neeranathan/2020/06/30/why-extreme-stress-causes-hair-loss/?sh=16884d1f4e6f

Back to Basics: Stretching

Mon, 30 Jan 2023 20:49:23 GMT

January 2023

"What day was it that I could no longer touch my toes?"

The quick answer is that it happens gradually.

We intuitively know that stretching could prevent this from happening and we've all been told how stretching is good for us. Some of us like how it feels, some of us deplore how inflexible we are, and some of us might even experience both situations!

The good news is that it doesn't take a lot, just a little every week, to benefit from the cumulative effect of stretching.

As for all new physical activity, prior to starting a regular stretching routine, speak with your doctor. You would also want to consult with a trained professional for proper stretching techniques, to avoid possible injury. Each person's ability and situation is specific to their age, medical history, fitness level, lifestyle, goals, etc. (Just as an example, isometric stretching and PNF stretching are not recommended for kids whose bones are still growing.)

FUN FACT:

The human body has approximately 600 muscles!

What is stretching and which muscles do we need to stretch?

To grossly simplify, when we stretch, we're increasing the ability of our muscles to lengthen. We work on pulling the muscle fibers to their full length, and then we engage the surrounding collagen fibers and connective tissue to align in the same direction of force. This realignment is what helps to rehabilitate scar tissue back to health.

When a muscle is stretched, some of its fibers lengthen and some remain at rest, so not necessarily all muscle fibers in a muscle are stretched. Incidentally, a fiber can either lengthen completely or not lengthen at all (it stretches all the way or it doesn't, it's all or nothing). The more fibers that are stretched, the greater length developed by the muscle. When we stretch, we train the muscles to become more accustomed to the new length. This in turn helps with flexibility and range of motion.

For those of you interested in the detailed physiology of it, please refer to the first two bullet points in the Resources and Reference section below. It's a fascinating process, from the message sent by the brain to the muscles, to the self-protective mechanisms (such as the Stretch Reflex and the Lengthening Reaction) that help to prevent injury.

For those of you who like shortcuts, here's one -- we don't need to stretch all 600 of our muscles! Just working on the major areas is helpful:

lower body - calves, hamstrings, hip flexors, quadriceps
core - lower back, hips
upper body - shoulders, neck

FUN FACT:

Our tendons and ligaments are protected by a function of the gogli tendon organ (GTO), which is located where a muscle is attached to the tendon (tendons connect muscle to bone). The GTO records the change in tension when a muscle contracts. When the tension exceeds a certain threshhold, the GTO inhibits the muscle from contracting further and instead causes it to relax!

What to watch out for

Don't overstretch or stretch too often - over doing it can cause injury. Don't stretch past your comfort level or where it starts to hurt. When stretching, expect to feel tension but not pain. Stretching too often can also put undue stress on the affected muscles. Start slow and with the guidance of a trainer or physical therapist.
Warm up before stretching - the idea is to get blood circulating in your muscles before stretching so that they are warm. 10-15 minutes of walking or going up and down stairs slowly or another warm-up that's accessible before stretching will help to prevent injury.
Choose your stretches - based on your goals, activities, capability, etc. to maximize the time you spend on stretching. Consider:
which muscle groups you'd like to stretch
what type of stretch is most suitable - for details about static, passive, dynamic, isometric, and PNF stretching, the 3rd bullet point in the Resources and References section below defines them clearly and includes some examples (they note that PNF stretching is currently generally considered the fastest and most effective way to increase flexibility)
varying your stretching regimen so that you alternate muscle groups each time

FUN FACT:

When we contract a muscle, not all fibers in that muscle contract. Thus, we can vary the strength of our muscle contraction (from strong to weak) depending on the number of muscle fibers that are recruited to contract. For example, you may have experienced lifting something more quickly or higher than expected because your brain thought it was heavier than it is and it told your body to recruit more muscle fibres to contract than necessary.

The benefits of stretching

Stretching can help improve flexibility which in turn can:

Lower your risk of injuries, including muscle strain
Boost your performance in physical activities
Help to increase range of motion in your joints
Increase blood flow and nutrient flow to your muscles, helping them to work more effectively

Overall, stretching regularly can provide daily benefits, from improving posture to making it easier to perform daily tasks, to doing better in sports or getting better physical training results.

FUN FACT:

To help increase underwater dive time, approximately 50% of a beluga whale's total body oxygen store is found in its skeletal muscle. In contrast, humans only store 15% of our oxygen reserves in our skeletal muscle (muscles that we control, for example, our leg muscles).

BONUS FUN FACT:

We couldn't resist including one more fun fact, this time about chimpanzees.

Why are chimpanzees stronger than humans?

Because they have more fast-twitch muscles than humans do!

Resources and References:

Massachusetts Institute of Technology (MIT) - detailed physiology of what happens when we stretch - https://web.mit.edu/tkd/stretch/stretching_2.html#SEC7
Accro Physical Therapists - great overview of the physiology of static stretching - https://www.acropt.com/blog/2017/8/10/the-physiology-of-stretching
MIT - definitions and some examples of types of stretching - https://web.mit.edu/tkd/stretch/stretching_4.html
South Dakota State University Extension - on benefits, timing, tips, examples of stretching - https://extension.sdstate.edu/benefits-stretching
Medical News Today - on benefits and safety tips - https://www.medicalnewstoday.com/articles/benefits-of-stretching#safety-tips
Nationwide Children's Hospital - on stretching - https://www.nationwidechildrens.org/specialties/sports-medicine/sports-medicine-articles/stretching
Mayo Clinic - excellent list of basic stretches - https://www.mayoclinic.org/healthy-lifestyle/fitness/multimedia/stretching/sls-20076840
Physio-pedia - on stretching for rehab professionals, including the "how" of rehabilitating scar tissue - https://www.physio-pedia.com/Stretching
Mayo Clinic - great tips for stretching - https://www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/stretching/art-20047931
National Library of Medicine - clinical commentary on the best type of stretching for a particular goal or outcome - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3273886/
Victoria, Austraila government - number and type of muscles in the human body - https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/muscles
Forbes - on types of stretches and examples - https://www.forbes.com/sites/nomanazish/2020/03/31/why-you-should-do-stretches-every-day-and-the-right-way-to-do-it/?sh=1d5cb34d45b6
National Library of Medicine - on chimpanzee strength - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5514706/
Cleveland Clinic - on the different types of human muscles - https://my.clevelandclinic.org/health/body/21787-skeletal-muscle
Research Gate - study about cetaceans storing oxygen in their muscles - https://www.researchgate.net/publication/12383453_Body_size_and_skeletal_muscle_myoglobin_of_cetaceans_Adaptations_for_maximizing_dive_duration
National Library of Medicine - on PNF stretching, its mechanisms and effect on range of mation - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3588663/

It's freezing!

Fri, 23 Dec 2022 20:34:53 GMT

Decemb er 2022

In these times of sub-zero temperatures (in both Fahrenheit and Celsius!) in Arkansas, we thought it might be fun to look at why we're not able to freeze ourselves and then thaw out alive at a later date.

One reason is that much of our body's cells is made of water. When water freezes, it crystalizes, and crystals would puncture our cell walls. Scientists have found ways to freeze some things like stem cells and embryos by putting them in a fluid that prevents water from crystalizing when it freezes, but they haven't been able to make it work for freezing more complicated life. The fact that water expands when it freezes also causes irreversable damage to our cell walls (for example, frostbite).

Freezing cells slowly (a.k.a. supercooling) could be a solution as it can prevent intracellular freezing, but it only works in certain specific circumstances, so it isn't a suitable technique for freezing animals. Another problem with supercooling our cells is that you can still end up with the frozen water crystal and beside it, the salts and everything else that was inside the cell. This chemical process, purification through crystallization, of course dashes hopes of the cell coming alive again after being thawed. To get around that, scientists freeze, for example, very small cells such as sperm cells in a special solution very quickly and the cells do come alive again when defrosted. That seems to be the limit so far since this method doesn't work on cells even a little larger, such as blood cells, let alone a whole human.

Research in this area continues, though, because being able to freeze cells or to induce torpor (state of decreased physiological activity) in a human without causing damage would be very useful. One example is for astronauts who could travel much greater distances without needing to take enormous amounts of food, oxygen, etc, with them into space. Another example is being able to freeze organs used for transplants. As scientists often do when faced with a problem, they look to nature for possible solutions.

As far as animals that don't migrate, we know that some warm-blooded animals survive through winter by hibernating. Their body temperature drops considerably and they live off their fat reserves. A black bear loses 15% to 30% of its weight during hibernation! Research continues on how hibernation works.

Scientists have also found that some cold-blooded animals such as turtles and frogs hibernate (under ponds, mud, or leaves), with an interesting twist at the cellular level. The fluid around their cells freezes, but not their cells, and they are able to survive sub-freezing temperatures using anaerobic metabolism (explanation below Resources and References at the end of this blog.) Some fish have another strategy: unique enzymes that allow their bodies to continue functioning at colder temperatures. Other fish, some teleost in polar regions, have "antifreeze proteins" that bind ice crystals in their blood to prevent widespread crystallization.

"Brown fat" in birds and other animals is another discovery that helps to explain how they survive in cold temperatures. Brown fat cells are rich in mitochondria, they burn energy and create heat, and they are activated by cold. Human babies have brown fat (which is why they don't shiver from cold until after about 6 months old), and human adults also have some brown fat.

Despite all these advances in knowledge about cryopreservation and hiberation, scientists haven't yet arrived at the stage where it can be applied to organs or people. Well, as researchers and scientists continue in their quest for knowledge, we're working on keeping warm!

We wish you much warmth for the season, both physical and in your hearts.

Season's Greetings from Brittany, Nick, and the whole team

Resources and References:

University of California at Santa Barbara on freezing humans - http://scienceline.ucsb.edu/getkey.php?key=3132
ACS on hibernation in cold and warm blooded animals - https://www.acs.org/education/resources/highschool/chemmatters/past-issues/archive-2013-2014/animal-survival-in-extreme-temperatures.html
World Scientific on fish antifreeze proteins - https://www.worldscientific.com/worldscibooks/10.1142/4917#t=aboutBook
Live Science on what is brown fat - https://www.livescience.com/49652-what-is-brown-fat-facts.html
Discover Magazine on wildlife surviving in winter - https://www.discovermagazine.com/planet-earth/how-does-wildlife-survive-winters-freezing-temperatures
The Nature Foundation of Will County on how animals endure winter - https://www.reconnectwithnature.org/news-events/the-buzz/how-animals-endure-worst-winter-weather/
Science Daily on wood frogs freezing and thawing cycles - https://www.sciencedaily.com/releases/2014/07/140722164359.htm
National Park Service on wood frogs in Alaska - https://www.nps.gov/gaar/learn/nature/wood-frog-page-2.htm
Science Direct on supercooling - https://www.sciencedirect.com/topics/earth-and-planetary-sciences/supercooling
Appalachian History on wood frogs - https://www.appalachianhistory.net/2019/02/the-frog-who-freezes-solid-for-the-winter.html
Business Insider on why babies don't shiver - https://www.businessinsider.com/babies-dont-need-to-shiver-2015-10
Science Direct on supercooling - https://www.sciencedirect.com/topics/earth-and-planetary-sciences/supercooling
December 2022 edition of Wired magazine article about hibernation research for space travel - "The Hibernator's Guide to the Galaxy"
National Library of Medicine on cryopreservation - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5395684/

Cellular activity in cold-blooded hibernators:

Scientists have observed that water in between the cells freeze, but not water in the cells. How does this work? As water becomes ice outside the cell, the concentration of water inside the cell becomes greater and the water moves outside the cell. This is due to osmosis, where water goes from an area where there is less solute (solute is a dissolved substance, such as salts and other things in or around cells) to where there is more solute. There is more solute in the area around the cells relative to water because the quantity of liquid water there decreases as it turns into crystals. Thus, water flows out of the cell to equalize the concentrated solution outside the cell.

At the same time, a large quantity of glucose migrates into the cells, and it acts as an antifreeze by lowering the freezing point of water. Glucose is also the substance used for anaerobic metabolism (which is how the wood frog survives). Thus, the animal's cells are protected even in sub-freezing temperatures.

To note, when the wood frog, which uses this glucose (and urea) strategy in winter, defrosts in spring, it's the heart that defrosts first and starts beating. Then the brain activates, and the legs start to work.

What is the ONE thing you can do to improve your health?

Tue, 22 Nov 2022 01:24:11 GMT

November 2022

The quick answer is ... start now . Whatever healthy change you choose to start with, what will make the most difference is to just start!

Each person's situation is different, and sure, we know that we should eat more healthy foods, stop smoking, exercise more, etc.. It could get overwhelming, but there isn't a rule that says we can't start small. In fact, any healthy change is a change in the right direction, and it's never too late to start . Our bodies are amazingly responsive and keeping up the small, healthy changes will make us feel better and contribute to a healthier, more enjoyable life.

Some tips that work for us

Eating healthy:

Psst, we love our food! We've also found ways to enjoy what we like and still be healthy:

Don't overdo treats - and what works for us is to avoid the treats aisles so that we don't stock up. It's easier to have a healthy snack when there aren't treats in the house. We do get a little bit at a time though!
Take smaller portions - it's always possible to get seconds, so starting with a smaller portion and not loading up our plate completely helps. This is something that can work at big meals (like Thanksgiving dinner!), where we take a little bit of everything and then go back for a little bit more of veggies, whole grains, or what we like.

Exercising, keeping active:

Easing into being active - observers might think that what we start with is so small it's actually nothing, but we know that for example, the longer walk to the other side of the parking lot is actually making a difference for us. Or that the 2 measly push ups we manage to fit in before our shower can actually make our upper body stronger over time!
Finding physical activities that we like to do and switching it up from time to time - helps to keep it from getting boring.

De-stressing:

Finding a few minutes here and there during the day to do something we enjoy, to take the time to think about something (or to daydream!), or to just to do nothing - helps us to de-compress and not let stress accumulate.
Friends - we love to meet up with friends!
Sleep - we jealously guard our sleep time, which is of course a lot easier for people without babies or small kids. Parents can also, depending on their specific situation, figure out ways of getting sufficient sleep so that they feel refreshed. Since sleep affects immune function, cognitive function, mood, etc., everyone benefits!

As someone once said, I take care of my health and leave it to the medical professionals to take care of illnesses.

Workout Fuel

Fri, 28 Oct 2022 13:23:13 GMT

October 2022

Several of us at The Pharmacy at Wellington are training to participate in the various distances of the Little Rock Marathon in March 2023. We thought it might be useful to share one aspect of our training with you, how we fuel our workouts.

Our bodies require nutrients and energy to improve and to perform at their best, so to have everything on our side and to maximize on our workouts, we rely on science and our personal experience and preferences to fuel up, both before, during, and after our workouts.

Please note that the information here relates specifically to us and is general in nature. Your situation may be different, since each person has specific food preferences, diet, allergies, and health conditions. Also, you'll want to consult with your physician before starting an exercise program.

Timing counts

Pre-workout food and drink

Some of us prefer to do our practice runs in the morning and others prefer the afternoon or evening. Regardless, what we have found helpful is to have a small meal about 1 to 2 hours before working out. We time this so that it can be digested prior to the workout since the stomach needs blood to digest and our muscles also need blood during exercise. This small meal, along with water, means that we won't feel lightheaded or lack energy during the workout.

If it's a longer or more intense run (i.e. more than 60 minutes, or interval training), we'll also have a small snack a little bit before exercising (15-30 minutes). Some of us have experimented with the timing and type of small snack that works best for us, to prevent diarrhea.

During the workout

During a longer run, generally over an hour, we'll hydrate and have a small snack, to maintain energy levels.

Post-workout

After exercising, we'll have a meal within an hour or so, when our bodies are ready to refuel and rebuild muscle. We continue to hydrate, keeping in mind to replace electrolytes as well.

What types of foods are best?

Carbohydrates before and during, and carbohydrates and proteins after exercise. Water and electrolytes throughout.

Why?

Those of you who have subscribed to our monthly emails will know from last month's email where all the water is in our bodies. Essentially, we are 45% to 75% water (depending on our age, etc.), so it is vitally important that we keep a good water balance. (See our blog of August 2020 for guidance on how much water is enough: https://www.thepharmacyatwellington.com/back-to-basics-water )

As far as carbohydrates, our digestive system breaks them down into glucose or blood sugar. Our bloodstream absorbs glucose and uses it as energy to fuel our bodies. We are careful to choose starches and foods that contain fiber, the complex carbohydrates, rather than sweets that contain simple carbohydrates such as sugar.

Complex carbohydrates take a little longer to digest but are less likely to cause spikes in our blood sugar. They also contain essential vitamins, minerals, and fiber. As a result, our blood sugar levels remain stable and the feeling of fullness lasts longer.

Our bodies break down simple carbohydrates quickly and as a result, our blood sugar levels can rise and drop quickly. This is why after having a sweet, we may experience a burst of energy, followed by feeling tired. To note, simple carbohydrates are also associated with diabetes, heart disease, and high cholesterol.

Proteins after exercise help our muscles to replace their glycogen stores, which are essential to their smooth functioning.

Examples of good foods for fueling (and water throughout)

Pre-workout small meal

fruit and oatmeal - not instant oatmeal but ideally whole, steel-cut, or old-fashioned
blended fruit & yogurt with low sugar granola
toast with jam
brown rice with vegetables
a salad, or a pasta salad
pumpkin soup
pasta with vegetables

Pre-workout snack

trail mix
fruit - an apple, a banana, or a handful of grapes
some yogurt
some berries

During workout

a banana or a small apple
raisins
a small energy bar
an energy gel - these are usually made of simple sugars and some have electrolytes. They're designed to top off glycogen stores during long distance running.

Post-workout refueling

egg & whole wheat toast
peanut butter sandwich
a hard-boiled egg with whole wheat crackers
low sugar chocolate milk
whole grain chicken or turkey wrap
salmon & sweet potato
chicken, brown rice, & veggies
something with chickpeas, lentils, quinoa, etc.

We hope to see some of you at the race in March! In the meantime, we wish you good progress in your training and injury-free workouts!

References and additional information:

Mayo Clinic on eating and working out -- https://www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/exercise/art-20045506
Forbes Health on what to eat before a workout -- https://www.forbes.com/health/body/what-to-eat-before-workout/
The Cleveland Clinic on carbohydrates -- https://my.clevelandclinic.org/health/articles/15416-carbohydrates
Harvard School of Public Health on carbohydrates -- https://www.hsph.harvard.edu/nutritionsource/carbohydrates/
HSS (Hospital for Special Surgery) on fueling for sports -- https://www.hss.edu/article_eat-before-after-workout.asp
American Heart Association on fueling for sports -- https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/nutrition-basics/food-as-fuel-before-during-and-after-workouts
National Library of Medicine on glycogen metabolism -- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6019055/

What do people ask us pharmacists?

Fri, 30 Sep 2022 10:46:21 GMT

September 2022

What was that again?

Have you ever walked out of a pharmacy understanding how to take your medications and then the next day only vaguely remember the details? Or do questions come to mind only after you've hung up on the phone with us? Or maybe questions about medications just don't come to your or your loved one's minds...

Well, we'd just like to let you know that we're available to answer your questions, even the ones that you've asked before.

As pharmacists, we fully support your involvement in your healthcare -- we find that people who are informed and involved generally have better outcomes. We also work actively with physicians and specialists and bring our deep knowledge about medications to the table.

What should I ask?

Since it's usually easier to not start with a blank page, we thought that the sample questions below might help to trigger relevant questions for your or your loved one's specific situation. You can even just print off this page, check off the questions that apply to you, and bring in the printout the next time you visit us!

I took this medication yesterday and I still don't feel anything different. How can I tell if it's working?

What do I take this prescription for again? In fact, what do I take each one of these for?

¿Se habla español? -- Sí, nuestra farmacéutica Constanza está encantada de ayudar en español. Su biografía se encuentra al final de esta página: https://www.thepharmacyatwellington.com/about

Do any of my loved one's medications have adverse interactions amongst them? If yes, what are alternatives?
Are there any over-the-counter (OTC) remedies or vitamins that I should not be taking because of my condition or my prescriptions? Or the opposite, are there any OTC things I should be taking to help my medications work better?
Are there foods that I should avoid because of my medical condition. Or the opposite, are there foods that I should be eating more of because of my condition?
What could happen if I stopped taking this particular prescription?
Can you talk with my cardiologist about the best medication alternatives for me?
Oh no, I think I forgot to take a dose (or two) of my medicine. What should I do?
Are there changes that I can make to my lifestyle rather than taking this prescription?

How long should I be taking my medication? Can I stop taking it if I feel better?

How should I store my medication? How should I dispose of it?
Can you see if my baby's rash can be taken care of with an OTC medicine or if I should make a pediatrician's appointment?
I would like to quit smoking. What would you advise?
What time of day is best to take my prescription and why?

My elderly father doesn't remember anymore whether he should take his medication with food or not, and he can't see well enough to read the small print on the bottle label. What's best for him?

Would alcohol interfere with my medications? What's the threshhold for me?

How does stress impact my medication? What would you advise?

Can I get the new bivalent vaccine against COVID-19? -- The answer is yes, if you're 12+ and it has been at least 2 months since the last booster or the last of the initial series. Please go to the vaccines page of this website for the link to book.

Can I take both the flu and covid shot at the same time? -- The answer is yes. Book a flu shot (or flu mist, which is a spray rather than a shot) for the same day as your COVID-19 vaccine to ensure we'll have a dose for you, or just let us know when you come in for a COVID-19 vaccine.

I heard that people who are 50+ can get the new shingles vaccine. Is this true? -- The answer is yes. Please feel free to call us for details or drop by to get this vaccine.

Do you give travel vaccines? -- The answer is yes. Please call us for specifics.

It seems that my elderly mother takes a lot of medications. Can you do a comprehensive review of them for us? -- The answer is yes, please just bring in a full list of the medications the next time you come in.

When are our pharmacists available?

During our extended hours:

Monday to Friday -- 7 am to 9 pm

Saturday and Sunday -- 9 am to 7 pm

Who are our pharmacists?

They're a bunch of friendly, knowledgeable, and helpful people... read about them on our About Us page !

https://www.thepharmacyatwellington.com/about

New vaccine against COVID-19

Sun, 07 Aug 2022 17:18:05 GMT

August 2022

**UPDATE AS OF AUGUST 22, 2022** The Novavax vaccine has been approved for individuals 12+. Appointments available -- click on the vial above.

Please note that the information on this blog page is current as of the date of publication, August 6, 2022. The COVID-19 virus, vaccines against it, and the pandemic continue to evolve quickly, so we encourage you to consult the web pages of the CDC and FDA for the latest information.

What is the Novavax vaccine against COVID-19?

The Novavax vaccine is the fourth vaccine that the U.S. Food & Drug Administration (FDA) and Centres for Disease Control (CDC) have approved for use against COVID-19. It has been approved under Emergency Use Authorization (EUA).

The Novavax vaccine is a traditional, protein-based vaccine. The Pfizer-BioNTech and Moderna vaccines use mRNA (messenger RNA) technology and the Janssen (J&J) vaccine is an adenovirus vector vaccine.

Protein-based vaccine technology (used in the Novavax vaccine) - This traditional type of vaccine was developed almost 100 years ago (e.g. tetanus and diphtheria). The vaccine that is injected in our body includes only the harmless parts of the virus that best stimulate our immune system.

The Novavax vaccine contains synthetic, harmless S proteins, produced with the help of the fall armyworm insect and moths (see the last link below in the references section for details). Our body recognizes the S proteins as pathogens (things that cause disease) and fight them by creating antibodies and defensive white blood cells. Thus, we are protected if we later become infected with the COVID-19 virus.

The Novavax vaccine also has Matrix-M adjuvant which contains saponin extracts from the bark of the soapbark tree that is native to Chile. The ingredients list of the Novavax vaccine can be found in its Fact Sheet . The adjuvant facilitates a better immune response.
Viral vector technology (used in the Janssen vaccine) - This technology uses a modified, harmless version of a different virus (a vector, or a carrier) to deliver instructions to our body's cells. The cells produce harmless pieces of the virus, called antigens, which trigger an immune response in the body. Our body is thus trained to recognize COVID-19 and fight against it if we get infected after being vaccinated. This technology is also used in the Astra-Zeneca vaccine (approved outside of the U.S.).
mRNA technology (used in the Pfizer-BioNTech and Moderna vaccines) - This new type of vaccine provides instructions for our cells to make proteins to be able to train our immune system. mRNA is a type of RNA (ribonucleic acid). See our May 2021 blog about mRNA technology for more information about it.

Who is eligible?

Individuals 18+ who have not had any previous vaccine against COVID-19 are eligible.

Individuals who have been infected with COVID-19 can also get vaccinated, after their quarantine is completed and they are no longer symptomatic.

Can it protect me against new variants of COVID-19?

In a Phase 3 study conducted in the U.S. and Mexico during a period in which multiple variants (Alpha, Beta) were in circulation, vaccine efficacy against mild, moderate, or severe COVID-19 was 90%. There is insufficient data for Omicron.

The Novavax vaccine is still being studied in clinical trials.

Can I use the Novavax vaccine to "mix and match"?

The initial series of the Novavax vaccine is given in two doses, 3 to 8 weeks apart.

The Novavax vaccine is not given as a booster. At this time, boosters have not been approved for individuals who receive the Novavax initial series.

Can I get other vaccines at the same time as the Novavax vaccine?

There is no problem g etting Novavax or any of the other COVID vaccines with other vaccines with one exception, orthopoxvirus vaccines. Monkeypox is an orthopox virus and the two vaccines available for monkeypox are orthopoxvirus vaccines. So if an individual has received a dose of one of the vaccines against monkeypox, the CDC suggests waiting four weeks to get a COVID-19 vaccine dose.

References and Additional Information:

Ohio State University Wexner Medical Center - on viral vector vaccines - https://wexnermedical.osu.edu/blog/explaining-johnson-johnson-astrazeneca-vaccines
AstraZeneca - on viral vector vaccines - https://www.astrazeneca.com/what-science-can-do/topics/covid-19/covid-19-what-are-viral-vector-vaccines-and-how-do-they-work.html
Mayo Clinic - on different types of COVID-19 vaccines - https://www.mayoclinic.org/diseases-conditions/coronavirus/in-depth/different-types-of-covid-19-vaccines/art-20506465
Johns Hopkins - on the Novavax vaccine - https://publichealth.jhu.edu/2022/what-you-need-to-know-about-the-novavax-protein-based-vaccine
American Medical Association (AMA) - on what sets the Novavax vaccine apart - https://www.ama-assn.org/delivering-care/public-health/what-sets-apart-novavax-option-other-covid-19-vaccines
AMA - on Novavax vaccine questions - https://www.ama-assn.org/delivering-care/public-health/novavax-vaccine-questions-answered-sandra-fryhofer-md
Centers for Disease Control (CDC) - fact sheets for Novavax - https://www.fda.gov/emergency-preparedness-and-response/coronavirus-disease-2019-covid-19/novavax-covid-19-vaccine-adjuvanted#additional
World Health Organization (WHO) - on Novavax - https://www.who.int/news-room/feature-stories/detail/the-novavax-vaccine-against-covid-19-what-you-need-to-know
Science.org - on the Novavax vaccine - https://www.science.org/content/article/powerful-new-covid-19-vaccine-shows-90-efficacy-could-boost-worlds-supply
FDA briefing document - on Novavax - https://www.fda.gov/media/158912/download
New England Journal of Medicine - on the efficacy and safety of the Novavax vaccine, NVX-CoV2373 - https://www.nejm.org/doi/full/10.1056/NEJMoa2116185
University of Nebraska Medical Center - on the Novavax vaccine and moths and tree bark - https://www.nebraskamed.com/COVID/moths-and-tree-bark-how-the-novavax-vaccine-works

Additional references and information as of August 22, 2022:

CDC news release on the Novavax vaccine for adolescents - https://www.cdc.gov/media/releases/2022/s0822-novax-vaccine.html
CDC on Novavax overview and safety - https://www.cdc.gov/coronavirus/2019-ncov/vaccines/novavax.html

Healthy Bones

Fri, 29 Jul 2022 19:33:50 GMT

July 2022

Everyone wants healthy bones!

We know that bones that are strong do a better job of supporting us and protecting our organs. Having healthy bones also means a lower chance of getting osteoporosis (the silent disease of weak and brittle bones) when we get older. Our bones are useful in another way too -- they store certain minerals such as calcium and phosphorous and release them into the body when we need them for other uses.

Is it too late?

The good news is that it's never too late to care for our bones, and doing so comes with other positive side effects for our general health.

On the flip side, if we don't eat a balanced diet or don't get enough of the right kinds of exercises, our bones can become weak and have a higher chance of breaking. Broken bones can be painful and sometimes require surgery to heal. Unfortunately, people with osteoporosis can also be at risk for tooth loss. When the jawbone becomes less dense, tooth loss can occur.

Weak bones can cause long-lasting health problems.

Growing bones

Our bodies continuously make new bone and break down old bone throughout our lives. When we're young, we make new bone faster than we break down old bone, so our bone mass increases. Most people reach their peak bone mass around age 30. After that, bone remodeling continues, but we lose slightly more bone mass than we gain.

How likely we are to develop osteoporosis depends on how much bone mass we have by the time we reach age 30 and how rapidly we lose it after that. It's kind of like a bone bank -- the more we put in the bank before we're 30 and the more we can keep in there after that, the stronger our bones.

What can I do for healthy bones?

These are the key things we can do:

Eat a well-balanced diet rich in calcium and vitamin D - a healthy diet includes plenty of fruits and vegetables, whole grains, lean protein, and low-fat dairy products.
Get plenty of physical activity - the best exercises for healthy bones are strength-building and weight-bearing ones. For example, walking, climbing stairs, lifting weights, dancing, etc. Before starting a resistance training program, it is recommended to seek the advice of a fitness professional, especially for individuals with lower extremity joint conditions that may limit their ability to do weight-bearing exercise.
Maintain a healthy weight - severely restricting food intake and being underweight weakens bone in both men and women. Weight loss surgery and conditions such as celiac disease can affect the body's ability to absorb calcium, essential to bone health.
Don't drink too much and don't smoke - loss of bone mineral density is associated with tobacco use and excessive alcohol consumption (more than one drink per day for women and two for men). Smoking in any amount has damaging effect on bone density as it affects how well the bone building cells work.
Prevent falls - we should take action to prevent falls that can be prevented, for example those caused by loose rugs or poor lighting. Having our vision checked regularly and exercising every day to increase balance and strength can also help to prevent falls.

There are some risk factors for osteoporosis that are not within our control:

Age - the chances of getting osteoporosis increase as we get older because our bones become thinner and weaker as we age.
Gender - women have less bone tissue than men and women lose bone faster than men do because of hormonal changes after menopause. However, this does not mean that older men are not at risk for osteoporosis.
Family history - a parent or sibling with osteoporosis or having a family history of fractures may also increase our own risk.
Certain medications - long-term steroid therapy, for example, can be damaging to bone.

Consult for concerns

It is always best to enlist our doctor's help if we have questions about our risk factors for osteoporosis. They can recommend a bone density test and advise us on the best course of action.

In the meantime, it's up to us to make daily diet, physical activity, and other lifestyle choices!

References and Additional Information:

New York government on healthy bones and teeth - https://www.health.ny.gov/publications/2046/index.htm
National Institute of Arthritis and Muscculoskeletal and Skin Diseases on bone health information - https://www.bones.nih.gov/health-info/bone/bone-health/bone-health-life-health-information-basics-you-and-your-family
Cleveland Clinic on how to halt the thinning of your bones as you age - https://health.clevelandclinic.org/7-tips-for-healthy-bones-2/
Mayo Clinic on tips to keeping bones healthy - https://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/bone-health/art-20045060
Scotland's National Health Service with a great overview - https://www.nhsinform.scot/healthy-living/preventing-falls/keeping-well/looking-after-your-bones
UK's National Health Service on food for healthy bones - https://www.nhs.uk/live-well/bone-health/food-for-strong-bones/
American National Osteoporosis Foundation on Guide to a Healthy Bone Diet - https://www.bonehealthandosteoporosis.org/healthy-bones-guide/
American Academy of Orthopedic Surgeons on bone mass at different ages - https://orthoinfo.aaos.org/en/staying-healthy/healthy-bones-at-every-age/
National Institute of Arthritis and Multiskeletal and Skin Diseases on taking care of bones from a young age - https://www.niams.nih.gov/health-topics/kids/healthy-bones

Snot? That's Gross!

Sun, 26 Jun 2022 17:17:18 GMT

June 2022

Is it ok to pick my nose?

While kids might not think about asking this question, adults might wonder if there are downsides to picking one's nose, besides the social stigma. For that matter, is it ok to eat boogers?!

It is actually not a good idea to try to pry snot out of one's nose because it can carry bacteria and viruses, which can then spread from the hands to other surfaces touched. Similarly, germs on fingers can spread to the nose. Picking can also irritate the delicate tissues in the nose and make them more susceptible to infection.

As far as eating boogers, while it might not be harmful, it's safer to discourage the practice since snot is something that our bodies want to dispose of.

If excessive boogers are a problem, hydrating could be a good solution because it can keep mucus thinner and easier to manage.

Mucus or Mucous -- what is it?

Snot is a drier form of the slimy, sticky substance made by our bodies called mucus. Mucus is secreted by the mucous membranes, a protective layer which lines all the external cavities of our bodies exposed to the outside environment (nose, mouth, ears, etc.). Incidentally, "mucus" is the noun and "mucous" is the adjective.

Mucus lubricates and protects those parts of our body. Fun fact -- adults and adolescents produce about one to two quarts of mucus per day when healthy!

Nasal mucus - what do our bodies do with it?

Nasal mucus helps to protect the respiratory system, including the lungs. We breathe in approximately 2,600 to 3,000 gallons of air every day and our bodies like it warm (86+F) and humid (98%). Mucus keeps the lining of our nose moist and warms the air that we breathe and the mucus dries up a bit as it does its job. Mucus is up to 90% water and 10% ions, fats, and proteins. Proteins found in nasal mucus have specific functions: mucins make mucus sticky, peptides are antimicrobial, antibodies activate our immune system, and lysozymes chop up bacteria.

When we breathe air in, dust, dirt, pollen, and microscopic organisms can enter the nose at the same time. These items can irritate or infect our lungs, and our first line of defense is nose hairs, which trap the bigger items (like small insects!). We get rid of these irritants by sneezing. As for the smaller items, including dust, viruses and bacteria, the sticky mucus secreted by our mucous membranes traps them and they are transported by tiny hairs called cilia.

Cilia (different from the nose hairs mentioned above) are about the size of a red blood cell and they work (even against gravity!) to move mucus towards the throat, where it is swallowed. Imagine a live stage performer who jumps into the outstretched arms of the audience and who is transported by all those arms -- it's as if the mucus blobs are "crowd surfing"! It's a slow process, though, because cilia move together rhythmically about 10 to 20 times per second, transporting the mucus blobs only 0.2 inches per minute (that's about 12 times slower than a snail's pace!).

So once in the stomach, the dirty mucus is destroyed by the very acidic environment there and it doesn't make it into our bloodstream where it can cause us to get ill.

Some mucus, still in the nose and carrying trapped dirt and other debris, gets dry, clumps together, and doesn't make it to the throat, and that's when we're left with a booger. Boogers can be squishy and slimy or tough and crumbly. They are a sign that our nose is working the way it should!

To get rid of boogers, the best bet is to blow them out into a tissue.

Does my snot show that I'm healthy?

Generally, clear snot means we're not sick, although snot color is not used for diagnostic purposes.

We have all experienced extra mucus (stuffed up or runny nose, etc) when we're sick or when our sinuses are inflamed. Our bodies produce extra mucus to trap and get rid of the germs and the extra mucus is generally not swallowed. Our bodies try to quickly flush out the germs and the immune system adds extra white blood cells to the mucus. In fact, the greenish color of mucus when we're sick is due to neutrophils which capture and destroy invading bacteria or microorganisms.

See the 3rd bullet point in the references section below for detailed information about the color of snot!

References and Additional Information:

Children's Museum of Atlanta on what is snot, including recipes for making play snot - https://childrensmuseumatlanta.org/blog/what-is-snot/

Washington State University on the spelling of mucus and mucous - https://brians.wsu.edu/2016/05/25/mucus-mucous/

Cleveland Clinic's interactive chart on snot color - https://health.clevelandclinic.org/what-the-color-of-your-snot-really-means/

Nemours Children's Health on boogers - https://kidshealth.org/en/kids/booger.html

BBC on where snot comes from - https://www.bbc.com/future/article/20140321-where-does-snot-come-from

British Society for Immunology on boogers - https://www.immunology.org/public-information/immunology-related-activities-and-resources/the-secret-life-snot

Radio Canada on the nose - https://ici.radio-canada.ca/ohdio/premiere/emissions/moteur-de-recherche/segments/chronique/405492/nez-odeur-cinq-sens

Scripps on fun facts about boogers - https://www.scripps.org/news_items/6831-5-fun-facts-about-boogers

Fiber -- what's the big deal?

Sun, 29 May 2022 14:22:37 GMT

May 2022

Fiber -- what's the big deal?

Fiber, a natural component of plant-based foods, is a type of carbohydrate that our bodies can’t digest or absorb, what used to be referred to as “roughage”. It slows down digestion and helps to pass food waste more efficiently through the body, promoting bowel regularity. It is found mainly in fruits, vegetables, whole grains, and legumes.

You may have heard of the many health benefits of dietary fiber:

appetite and weight control,
enhanced nutrient absorption,
better blood sugar control,
Type 2 diabetes prevention,
reduced inflammation,
enhanced immune function,
protection against inflammatory bowel syndrome,
possible prevention of intestinal cancer,
constipation relief, and
healthier gut microbiota.

Adding to that, researchers have recently found that higher intake of fiber from cereals, in particular, is associated with lower risk of cardiovascular disease.

That gets it over the line for us – sign us up for more fiber! So … where to start? Since most of us don’t get enough fiber in our diet, let’s revisit the types of foods that are good sources of fiber, but first, here are a few quick tips:

Tip 1: Check with your doctor or pharmacist

Always check with your doctor or pharmacist before making big (even gradual) changes to your diet and before taking fiber (or other) supplements. They can advise on possible interactions with medications, interference with their absorption, or interference with their effectiveness, and provide suggestions that work for your particular situation.

Tip 2: Go slow

When a person suddenly increases their fiber intake dramatically, they may get side effects such as intestinal gas, bloating, constipation, nausea, diarrhea, and cramping. So they stop having fiber-rich foods and forgo the benefits.

The trick is to increase fiber intake slowly, over a few weeks, so that the natural bacteria in your digestive system has time to adjust. Make incremental changes on the way to a more fiber-friendly diet.

Tip 3: Drink 8 cups of water

Fiber works best when it absorbs water, so it is also important to drink plenty of fluids when increasing fiber intake. Recommendations vary (8 to 10 cups per day for males and 8 to 9 cups per day for females) and each person is different. As a rule of thumb, having urine that’s straw colored or lighter (except first thing in the morning) is a sign that you’re getting enough fluid.

Tip 4: Get fiber from food first before adding a supplement

Food provides a mixture of micronutrients, vitamins, minerals, phytochemicals, satisfaction of the taste buds, the feeling of fullness, and likely other things that we don’t yet understand that are absent in supplements. Our bodies appreciate all those other elements and it’s all the better if we don’t need to take a fiber supplement.

Tip 5: Older adults benefit from fiber

Inflammation and constipation, two conditions that a healthy diet including fiber can help with, tend to be more prevalent in older adults than in other age groups. All the more reason to increase fiber intake and/or to let a loved one know about its benefits.

Tip 6: Don't overdo it

While most of us don’t get enough fiber, some of you may. Here’s what’s recommended, per day:

for men aged 50 or younger – 38 grams
for men aged 51 or older – 30 grams
for women aged 50 or younger – 25 grams
for women aged 51 or older – 21 grams

Getting too much fiber is possible and the effects are not pleasant. Intestinal blockage, rare but serious, can occur with a high fiber diet where not enough fluid is consumed.

What foods are good sources of fiber?

The following list provides a sample of foods high in fiber. Choose a few that you enjoy and switch it around after a week or so, for variety!

Legumes – beans, dried peas, lentils, pinto beans, kidney beans, lima beans, garbanzo beans, etc. Legumes are also a good source of protein.

Whole grains – whole wheat breads and pastas, brown rice, bran cereals, rolled oats, barley, oatmeal, popcorn, etc.

Fruits – raspberries, pears, blueberries, strawberries, bananas, apples, pears, peaches, prunes, avocado, etc. Fruit eaten with the skin on are especially good.

Vegetables – broccoli, cauliflower, carrots, spinach, potatoes, sweet potatoes, string beans, peas, kale, etc.

Nuts and seeds – chia seeds, flax seeds, pumpkin seeds, almonds, pistachios, pine nuts, chestnuts, sunflower seeds, etc. Keep in mind that nuts and seeds are also good plant-based sources of omega-3 fatty acids, which have heart-protective effects. Plus, their high fat content can help you feel fuller longer.

Animal products don’t naturally contain fiber, but fiber can be added during processing and you can see the quantity on the food label.

Ongoing research

Finally, scientists are exploring and working further on the categorization of dietary fibers. Traditionally split into “soluble” and “insoluble”, they are finding that other factors come into play; for example, fermentability, viscosity, tolerability, and prebiotic activity.

While waiting for further research results, we’ll take out insurance by increasing the fiber in our diet slowly!

References and Additional Information:

Columbia University on how cereal fiber is linked with lower inflammation - https://www.publichealth.columbia.edu/public-health-now/news/not-all-dietary-fiber-created-equal-cereal-fiber-linked-lower-inflammation

Journal of Animal Science and Biotechnology on the classification of fiber - https://jasbsci.biomedcentral.com/articles/10.1186/s40104-019-0350-9

American Heart Association on needing more fiber in our diet - https://www.heart.org/en/news/2022/01/27/sound-the-fiber-alarm-most-of-us-need-more-of-it-in-our-diet

Duke University on practicalities of increasing fiber in diet - https://studentaffairs.duke.edu/sites/default/files/u110/TooMuchFiber082015.pdf

National Library of Medicine on the Effects of Dietary Fiber and Its Components on Metabolic Health - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3257631/

Australian government on high fibre foods - https://www.healthdirect.gov.au/high-fibre-foods-and-diet

Scientific American and Monica Reinagel on types of fiber and their benefits – https://www.scientificamerican.com/article/fiber-2-0-fibers-new-science-of-health-boosting-benefits/ and https://www.quickanddirtytips.com/health-fitness/healthy-eating/new-fiber-benefits?utm_source=sciam&utm_campaign=sciam

U.S. News & World Report – on types of fiber and how to integrate fiber into our diet - https://health.usnews.com/health-care/patient-advice/articles/what-is-fiber-and-how-you-can-get-enough

CDC on fiber - https://www.cdc.gov/diabetes/library/features/role-of-fiber.html

Academy of Nutrition and Dietetics on ways to boost fiber - https://www.eatright.org/food/vitamins-and-supplements/types-of-vitamins-and-nutrients/easy-ways-to-boost-fiber-in-your-daily-diet

UCSF on how to increase fiber intake - https://www.ucsfhealth.org/education/increasing-fiber-intake

Cleveland Clinic on the fiber content of common foods - https://my.clevelandclinic.org/health/articles/14400-improving-your-health-with-fiber

Harvard School of Public Health on types of fiber - https://www.hsph.harvard.edu/nutritionsource/carbohydrates/fiber/

Mayo Clinic on nutrition and healthy eating, and on whole grains – https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/fiber/art-20043983 and https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/whole-grains/art-20047826

Duke University on high-fiber diets - https://studentaffairs.duke.edu/sites/default/files/u110/TooMuchFiber082015.pdf

Oklahoma State University on dietary fiber - https://extension.okstate.edu/fact-sheets/dietary-fiber.html

Drug Take Back Day

Fri, 29 Apr 2022 07:49:14 GMT

April 2022

Keep medications from finding their way to the street

While medications are vital to the health and well-being of patients, they can fall into the wrong hands, both intentionally and unintentionally.

Clean out your or a loved one's medicine cabinets and bring the unwanted medications safely, anonymously, and for free -- to National Drug Take Back Day on Saturday, April 30, 2022 .

We are a drop-off site for the bi-annual event and Pulaski County Sheriffs will be at The Pharmacy at Wellington from 10 am to 2 pm to accept the medications.

Why bring them in?

Self medicating using drugs that were previously prescribed for another condition can be dangerous and sometimes fatal. You may be taking other medications today that you weren't before that could cause serious interaction with the old drugs. The smart thing to do is to consult with your doctor or pharmacist about a current condition. If you need medication as part of the treatment, you can get a new prescription or over-the-counter drug.

When you shelve old medication and forget it, it's available for the taking -- by everyday workers, friends, and guests who come through the home through the years. The majority of teenagers who abuse prescription drugs get them from family and friends -- and the home medicine cabinet.

Unused prescription drugs thrown in the trash can be retrieved and used for abuse or illegally sold. Flushing them down the toilet contaminates the water supply.

Did the mail order pharmacy send too many drugs to you or to a loved one?

Drive up and drop off the unwanted or expired prescription medications!

Year-round drop off

Dispose of drugs safely at National Drug Take Back Day or drop them off another day at The Pharmacy at Wellington. We are an authorized collection site and our drug drop box accepts the following:

Let's help and do our part!

References and Additional Information:

Substance Abuse and Mental Health Services Administration - about the rise in prescription drug misuse and abuse impacting teens - https://www.samhsa.gov/homelessness-programs-resources/hpr-resources/rise-prescription-drug-misuse-abuse-impacting-teens

National Kidney Month

Fri, 25 Mar 2022 02:00:49 GMT

March 2022

Image Credit: U.S. National Institute of Diabetes and Digestive and Kidney Diseases

Introducing... your kidneys

We generally know that our kidneys filter waste and produce urine, but they do much more than that! Bean-shaped and about the size of a fist, located justed below the rib cage and on each side of our spine, healthy kidneys:

Filter about half a cup of blood every minute, removing wastes and extra water to make urine;
Remove acid that is produced by the cells of our body, thus regulating the pH of our blood;
Maintain a healthy balance of water, salts, and minerals - such as sodium, calcium, phosphorus, and potasium - in our blood. This balance is necessary for our nerves, muscles, and other tissues to work normally; and
Make hormones that help to:
control our blood pressure,
make red blood cells (they deliver oxygen to different parts of our body), and
keep our bones strong.

But what can go wrong?

Kidney Stones

When there is too much waste in the blood and the body is not producing enough urine, crystals begin to form in the kidneys. These crystals attract other wastes and chemicals to form a solid object, a kidney stone, that will get larger unless it is passed out of the body in urine.

Kidney stones can be as small as a grain of sand or as large as a golf ball.

Passing kidney stones can be quite painful, but the stones usually cause no permanent damage if they're recognized in a timely fashion. Depending on the particular situation, a person with kidney stones may need nothing more than to take pain medication and drink lots of water to pass a kidney stone. Other situations may necessitate surgery; for example, if stones become lodged in the urinary tract, if they are associated with a urinary infection, or if they cause complications.

Chronic Kidney Disease

Kidneys can get damaged and not filter waste and extra fluids as they should. When this happens over time, it is called Chronic Kidney Disease (CKD). In the early stages (Stages 1–3) of CKD, the kidneys are still able to filter waste out of our blood. In the later stages (Stages 4–5), they must work harder to filter blood and may stop working altogether. The goal at each stage is to slow down the damage to the kidneys and keep them working as long as possible.

In Stages 4 and 5 of CKD, severe kidney damage means that they are close to not working at all or have failed. At this point, waste products build up in the body, causing major health problems. When kidneys fail, treatment options to survive include dialysis or a kidney transplant.

Risk Factors

A person who has a family member with kidney disease, a diabetic, or a person with high blood pressure or heart disease, all have a higher chance of developing kidney disease than people without those risk factors. It doesn't mean that the person will definitely have kidney disease, but the chances of developing it are higher. As well, the risk increases with age.

While one may live 10 to 20 years on dialysis, it would entail a lifestyle that one would rather avoid. So what can we do to help keep our kidneys healthy?

The Key -- Personalized Kidney Care

Image Credit: U.S. National Institute of Diabetes and Digestive and Kidney Diseases

"An ounce of prevention...

... is worth a pound of cure", as the saying goes, and it certainly applies to keeping our kidneys performing at their peak. The good news is that putting into practice the tips above also helps with preventing and/or treating other conditions (such as high blood pressure and diabetes) so there's no reason to delay doing so!

Considering that a person can lose up to 90% of their kidney functions before experiencing any symptoms, an effective way to detect kidney disease is regular doctor's check-ups, including blood and urine tests.

Kidney Transplants

It might be comforting to know that as far as organ transplants go, kidney transplants are the most common and success rates continue to improve. On average, a kidney from a donor can last 15 to 20 years. Of course, getting a kidney transplant isn't without risks and potential complications, not to mention having to take immunosuppressive medications for life, to prevent organ rejection.

In November 2021, 90,000 patients (especially those with O or B blood types) in the U.S. were on a waiting list for a kidney transplant. For reference, it is possible to sign up to be an organ donor upon one's death, to help with the shortage of kidney donations that allow for the life-saving transplantation procedure. Click on the ARORA (Arkansas Regional Organ Recovery Agency) logo below to find out more or to sign up:

References and Additional Information:

What the kidneys do - https://www.niddk.nih.gov/health-information/kidney-disease/kidneys-how-they-work
Stages of Chronic Kidney Disease - https://www.kidneyfund.org/all-about-kidneys/stages-kidney-disease
Kidney stones - https://www.kidneyfund.org/all-about-kidneys/other-kidney-problems/kidney-stones
Kidney stones - https://www.mayoclinic.org/diseases-conditions/kidney-stones/symptoms-causes/syc-20355755
Dialysis - https://www.kidneyfund.org/treatments/dialysis
Dialysis - https://my.clevelandclinic.org/health/treatments/14618-dialysis
Health plan - https://www.niddk.nih.gov/-/media/Files/Health-Information/Community-Outreach/NKM-2022/NKM2022_Flyer_English_508-Compliant.pdf
Chronic Kidney Disease - https://www.niddk.nih.gov/health-information/kidney-disease/chronic-kidney-disease-ckd/what-is-chronic-kidney-disease
Diagnosis - https://www.worldkidneyday.org/facts/chronic-kidney-disease/
Reduce NAIDs and other tips - https://www.kidney.org/news/national-kidney-month-take-five-your-kidneys
Kidney transplants - https://www.kidney.org/transplantation/livingdonors/general-information-living-donation
Kidney transplant statistics and info - https://kidney360.asnjournals.org/content/2/11/1836

Healthy Skin Habits

Wed, 02 Feb 2022 18:14:15 GMT

January 2022

Taking care of our skin

We know that not smoking, using sunscreen, drinking plenty of water, and eating a good diet are ways to help reduce premature skin aging. We can start doing these things anytime because the body benefits from healthy lifestyle changes at any age.

Studies in the last decade also point to a fairly easy way to help our skin age gracefully: endurance training.

What is endurance training?

It generally refers to exercising to increase cardiovascular endurance, for example running, cycling, brisk walking, or swimming, but it can also refer to non-traditional cardiovascular activities such as dancing, playing tennis, or roller skating, etc.. Involving the whole body in moderate to vigorous physical activity increases heart rate and respiration, which train the heart and lungs to work better. This is aerobic training, which uses oxygen in the production of energy.

Endurance training happens over time and a general rule of thumb is to not increase the duration or intensity by more than 10% per week. Spreading the activity throughout the week is also good practice as that gives the body time to rest and repair itself.

Since muscles help to support cardiovascular training, endurance training sometimes also refers to muscular endurance, or strength training. This is anaerobic training, where the body breaks down glucose for energy, without using oxygen.

How does endurance training help our skin?

A study published in 2015 shows that endurance exercise reduces age-associated changes to skin by regulating activity (chemical reactions) in mitochondria. Mitochondria are special compartments (organelles) in cells that are best know for their role as powerhouses because they produce a molecular fuel used by the rest of the cell for energy.

Skeletal muscle (muscles attached to bones by tendons) contain muscular AMPK, which plays the role of energy sensor, particularly crucial in tissues that have constantly changing energy demands. The study found that mice lacking muscle AMPK have reduced serum IL-15, a hormone that regulates mitochondrial function. Reduced levels of IL-15 is associated with impaired mitochondrial metabolism, related to the deterioration of skin structure, which can lead to accelerated skin aging.

When the authors of the study compared sedentary mice to those who exercise on a wheel three times a week, they found "massive systemic benefits". "One of our most striking findings was the skin,” said Mark Tarnopolsky, MD, PhD, study coauthor and director of the Neuromuscular and Neurometabolic Cinic at McMaster University Medical Center in Ontario, Canada. “It was dramatically abnormal in the aging mouse and completely protected with exercise.”

To test the theory further, they looked at skin biopsies of humans, taking samples from the upper buttocks, an area that wouldn’t be exposed to damage from the sun. They found that skin from older athletes was healthier than that of older sedentary folks. Then they enrolled a subset of the sedentary elderly adults, aged 65 and older, in a 3-month moderate cycling exercise program to more directly determine the ability of exercise to reverse age-related changes to human skin. After 3 months, they found that the skin of this subset group had increased collagen content and that it appeared 20 to 30 years younger under the microscope.

The findings thus indicate that exercise can attenuate some aspects of skin aging in humans and that these changes are associated with improvements in tissue mitochondria.

The secret's out !

We know that exercise is generally good. Among the benefits, it:

reduces stress
helps improve sleep
controls weight
boosts energy
combats health conditions and diseases

So, now you also know that it may help you have a younger-looking complexion! Find an aerobic activity that you like to do and go for it!

** As always, check with your doctor prior to starting an exercise routine. **

References and Additional Information:

Definition of endurance exercise - https://en.wikipedia.org/wiki/Aerobic_exercise
Doing cardio exercises correctly - https://www.verywellfit.com/cardiovascular-exercise-principles-and-guidelines-3432613
What are mitochondria - https://www.mrc-mbu.cam.ac.uk/what-are-mitochondria
Study: Exercise-stimulated interleukin-15 is controlled by AMPK and regulates skin metabolism and aging - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4531076/
What is AMPK - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5945561/
Skin layers - https://www.ncbi.nlm.nih.gov/books/NBK470464/
Types of muscle - https://my.clevelandclinic.org/health/body/21787-skeletal-muscle
AMPK regulates skeletal muscle metabolism and gene expression - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1817795/
Why does your skin age? - https://sites.dartmouth.edu/dujs/2013/01/28/why-does-your-skin-age/
Aging changes in skin - https://medlineplus.gov/ency/article/004014.htm
Exercise and mitochondria - https://www.everydayhealth.com/skin-beauty/the-scientific-reasons-why-exercise-can-give-you-better-looking-skin/
CBC on preliminary results of the study - https://www.cbc.ca/news/canada/hamilton/headlines/want-your-skin-to-look-20-to-30-years-younger-try-this-1.2614411

QR Code for COVID-19 Test Results

Mon, 06 Dec 2021 14:44:07 GMT

**Please note** As of March 2023, we no longer provide QR codes for COVID-19 test results.

December 2021

We provide a QR code with your COVID-19 TEST result. It can be used* for:

International or domestic travel
Work
School
Entry into events
Etc.

Get a rapid curbside COVID-19 test from us -- we will call you with the results within one hour, and within two hours, we will email you a receipt and text you a QR code that links to your test results.

You will receive a QR code from us for the following curbside COVID-19 tests:

Rapid PCR test

Rapid Antigen test

*QR codes and/or the type of test may or may not be accepted, depending on the requirements of your purpose. Please check with your destination, the organizers of your event, the school administrators, etc.

Please see our Rapid Tests page for details about each of our tests. Booking a rapid curbside test on our calendar is easy:

Additional information:

Can I manage my family's results all on one phone?

Yes, you can give us one phone number for all of the tests and the QR code will be texted to one cellular number.

Is the QR code secure?

Yes, our QR codes comply with HIPAA and international standards. Your information is stored and transmitted via HIPAA-compliant means. To access your personal data, someone who scans your QR code must also have your name and date of birth. Please note that by giving your name and date of birth to another person and allowing them to scan your QR code, you are giving them permission to access your personal data.

Does it cost me extra to get the QR code?

No, the price is the same for our COVID-19 tests, whether you need a QR code or not. All individuals who receive a rapid COVID-19 test from us and who provide us with their phone number and email address will receive a QR code with the result.

How does the QR code work?

It is simply a link to a digital version of your test results. To see your own results on your phone, click on the website link provided under the QR code in the text that you receive. To see someone else's results using a QR code on their phone, "take a photo" of their QR code and click on the link to the internet page instead of the button to take the photo. A device or app that specifically scans QR codes can also be used.

What does the test result certificate look like?

Here is a sample of what the QR code links to, after your name and birthdate are entered:

Do I need a negative test result in addition to being vaccinated? Do I need to get a booster to be able to travel internationally? What kind of test, PCR or Antigen, do I need? Is your test accepted everywhere?

If getting tested for COVID-19 and having a negative test result are necessary for what you want to do, please check and double check the requirements for your particular purpose. This is because:

Some destinations continue to require testing upon arrival, regardless of vaccine status. Other destinations require full vaccination in addition to a negative test result.
"Fully vaccinated" may mean two doses of an mRNA or one dose of the Janssen vaccine, or a booster as well. The meaning of "fully vaccinated" can vary depending on requirements.
Some locations require that COVID-19 tests be performed by a testing center that is on their list of pre-approved or local facilities.
Some locations require you to quarantine while awaiting local test results, or regardless of pre-departure test results.
Some destinations will only accept PCR tests where samples are analyzed by a laboratory, rather than a rapid PCR test such as ours.
For some purposes, you must also have a QR code for your vaccination status.
Etc.

*Checking the requirements for what you want to do is your best bet to ensure that your test results can be accepted.

Can I print out the QR code?

Yes, and that is advisable so that you have a paper back-up that can also be scanned. You might want to print out a copy of the results page as another back-up.

You would also want to plan it so that your phone will have sufficient battery life for when you need to show the QR code. To note, once you've received the text with your QR code, that text can still be shown even if your cell phone is in airplane mode. However, if you want to access the web page that it links to on your phone , your phone must have access to the internet.

What is GoRev?

It is the supplier company that we use to provide QR codes for our COVID-19 tests.

Sweet, sweeter, sweetest

Fri, 29 Oct 2021 11:15:35 GMT

October 2021

Sugars

With so much hype about there being too much sugar in the American diet, it can be hard to figure out what the sensible thing to do is, especially in the context of Halloween. And yet, sugar is a carbohydrate that our bodies need and use for energy. Let's dig into this a bit more...

Naturally-occurring sugars include lactose in milk, fructose in fruit and honey, glucose in fruits and vegetables, maltose in wheat and barley, sucrose, etc.
Added sugars is the name given to sugars that are added to a food or beverage. Sugars are added for many reasons: to make food taste sweeter, extend its shelf life, add volume, balance acidity, preserve, improve its appearance, etc.

The benefit of naturally-occurring sugars is that they are found with other naturally-occurring fibers, minerals, protein, antioxidants, and more. The presence of these key nutrients, especially fiber, helps slow down the absorption process of the naturally occurring sugar, helping us avoid over-consumption.

Added sugars, on the other hand, are quickly digested and absorbed by our bodies, making it easier to over-consume. They are generally found in foods that are low in vitamins and minerals and generally high in calories, what are called "discretionary foods", or foods that are not necessary to meet our dietary needs. These energy-high foods and beverages can also displace the more nutritious foods in our diet.

Consuming too much added sugars may:

Contribute to weight gain since it is easy to get extra calories when consuming foods and beverages that are sugar-sweetened. Becoming overweight can increase the risk of type 2 diabetes, as well as some cancers and stroke. For children, consuming too much added sugars may also set the stage for obesity as an adult.
Increase triglycerides, which are a type of fat in the bloodstream and fat tissue. Increased triglyceride levels may increase the risk of heart disease.
Increase tooth decay because high-sugar diets can feed bacteria that produce acid which attacks tooth enamel, causing permanent cavities in teeth.
Lead to a greater accumulation of fat in the liver, which may lead to fatty liver disease.

One way of lowering added sugars is to choose wholegrain carbohydrates instead of refined carbohydrates (such as white pasta and white rice).

Making a habit of reading labels on processed foods and learning what to look for will also help. After all, not taking home foods and beverages high in added sugars would encourage a healthier diet. As far as labels, you'll want to look at:

the ingredients list — ingredients are listed in order of weight. The higher up the list, the bigger the proportion of that ingredient. Sugars may be listed as sucrose, glucose, dextrose, maltose, golden syrup, maple syrup, molasses, coconut sugar, agave syrup, high-fructose corn syrup, or others.

the nutrition facts panel — sugars are listed under ‘Carbohydrates’. When comparing a regular version and a low sugar version of a product, you'll want to see how much sugar each has for the same serving size. If the serving sizes are different, compare how much sugar there is in the same amount of the food or beverage, for example, in 100 grams.

Some options for consuming less added sugars include:

buying plain, unsweetened yogurt and sweetening it with fruit if you wish,
drinking plain water or unsweetened drinks rather than sodas or energy drinks,
flavoring foods with herbs and spices,
using less sweetners at the table (this includes molasses, syrup, maple syrup as the body processes those as sugar),
avoiding canned fruit in syrup, especially heavy syrup (opt for fresh fruit or canned fruit in water),
cutting back on the sugar when baking (you'll probably not notice the difference if you cut the sugar in a recipe by 1/3 to 1/2).

Are sugar substitutes better?

The three types of sugar substitutes are:

Artificial sweeteners — for example: aspartame, saccharin, and sucralose. They have no calories and are used widely by the food industry in products labelled ‘diet’ or ‘no sugar’. (However people with the rare genetic condition phenylketonuria, or PKU, can't have aspartame since it contains an amino acid, phenylalanine, that their body can't break d own.) Some artificial sweetners are many times more sweet than sugar, so only a small amount is needed. This is the case for Sucralose, sold under the name Splenda, which is 600 times as sweet as sugar.

Nutritive sweeteners — for example: fructose, isomalt, mannitol, xylitol, sorbitol, and polydextrose. They contain calories and have the same (or less) energy than sugar.

Natural intense sweeteners — for example: stevia and monk-fruit extract. They are calorie-free and generally made from plants. Because they are much sweeter than sugar, only small amounts may be needed.

Some artificial sweetners that replace sugar can be calorie free, but they may still increase the chance of tooth decay. Evidence is mixed as to whether artificial sweetners help with weight loss, especially in the long term.

How about cutting out sugar altogether?

Diets that restrict all or just added sugars can result in short-term weight loss but that may not be sustainable.

A zero-sugar diet would involve cutting out all fruit and vegetables, milk, and some grains and legumes because of their natural sugar content. This puts a person at risk of nutritional deficiencies and is not recommended.

It is important to note that healthy carbohydrates are also needed by the beneficial gut bacteria that keep our digestive tract healthy.

The smart alternative is to restrict added sugars since they are common in high-calorie, nutrient-poor, discretionary foods and drinks.

What to do?

It definitively takes a combination of will power, smart meal and snack planning, and support from family and friends, and it is not always possible to restrict added sugars or reduce our sugar intake -- we recognize that we're all human! Nevertheless, we could try it out by putting into practice any or all of these options:

Ease into avoiding added sugars - Cut out or replace staples that you usually buy that contain a lot of added sugars, little by little. You might try initially replacing just breakfast cereals, for example, with eggs and brown toast, or unsweetened yogurt and fruit, etc. Then a month later, start taking an apple to work every day so that when you feel like snacking in the afternoon, you'll have an apple instead of a candy bar or a cookie.

Moderation is key - It's ok to have an energy drink or pancakes and syrup from time to time. What's important is moderation.

Be aware of the sugar content in foods that you consume - Take a look at the label of processed foods to have an idea of your daily sugar intake. It's knowing where you're consuming the sugar that will allow you to make changes that give you the biggest "bang for your buck".

Don't be discouraged or feel guilty - It's ok to treat yourself, it's ok to not have will power of steel, and it's ok to feel that you didn't do what you set out to do for that day. Simply start over the next day! Just take each day (or break it down to each half day if that works better for you) as a new start and keep at it because it's the longer-term trend that counts.

Be aware of the sugar and added sugars that your kids consume and discuss with them how they can reduce their sugar intake and what changes they're ready to commit to. Setting them up for success from a young age will be helpful for their long-term health.

Several of us at The Pharmacy at Wellington have tried these tips over time and they do work. Just persevere and change it up occasionally to keep your diet interesting and full of flavor. We're sure that you'll feel healthier for it!

For Halloween

To help build a healthier community, you might want to consider giving away non-edible items to trick-or-treaters, to avoid the question of sweets altogether. Some ideas:

plastic creepy crawlies
orange / black / bright green putty
themed pencils
themed erasers
bubble makers
glow-in-the-dark bracelets or necklaces
themed stickers
etc.

S-W-E-E-T !

References and Additional Information:

US HHS on reading food labels -- https://www.nia.nih.gov/health/reading-food-labels
US FDA on nutrition facts labels -- https://www.fda.gov/food/new-nutrition-facts-label/how-understand-and-use-nutrition-facts-label
US FDA on high-density sweetners -- https://www.fda.gov/food/food-additives-petitions/additional-information-about-high-intensity-sweeteners-permitted-use-food-united-states
Michigan State University on sweetners -- https://www.canr.msu.edu/search?tag=sweetener
American Heart Association re tips on cutting down sugar -- https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/sugar/tips-for-cutting-down-on-sugar
UC Berkeley Sather Health on artifiical sweetners -- https://www.ocf.berkeley.edu/~sather/artificial-sweeteners-not-as-sweet-as-they-appear/
Science News on artificial sweetners -- https://www.sciencenews.org/blog/scicurious/sour-side-artificial-sweeteners
Australian New South Whales Health on sugar alternatives -- https://www.health.nsw.gov.au/heal/Pages/sweeteners.aspx
Mayo Clinic on artificial sweetners -- https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/artificial-sweeteners/art-20046936
Mayo Clinic on added sugars -- https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/added-sugar/art-20045328
Department of Health, Australia, on sugar -- https://www.healthdirect.gov.au/sugar

Pharmacist in ... Japan

Thu, 23 Sep 2021 01:22:27 GMT

September 2021

This month we are excited to host a guest blog, by one of our former interns and employees, now pharmacist, Natalie! She shares her initial experience of living and being a new pharmacist in Japan:

I think most people would agree that moving away from your childhood home is a pretty scary feat. Now imagine if that move was to an entirely new country where you could count the number of people you knew on one hand. Are you imagining it? Welcome to my new normal!

My name’s Natalie and I am a 2021 UAMS College of Pharmacy Graduate. During my last year of pharmacy school, one of my rotations was at The Pharmacy at Wellington where I was fortunate enough to be hired on as an intern working mainly in the vaccination clinic. About two months ago, my husband, Alex, and I packed up all of our belongings and moved to Japan for his job! We will be stationed at an Air Force base in Japan for at least 3 years. Living in another country for a significant period of time is not something that many people have the opportunity to do, so I thought it would be fun to share the experiences that this new phase of life has brought me as well as the challenges of practicing pharmacy in a very foreign land.

Our first few weeks in Japan were mostly spent “in-processing” and getting as settled as possible, so I won’t bore you with all those details. Instead, I’d prefer to talk about the questions all of my family and friends asked me after being in Japan for two weeks. I know one of the questions that burns in everyone’s mind is “what’s it like driving in Japan?” Well, to put it simply, it’s significantly different. In Japan, everyone drives on the left side of the road, the steering wheel is on the right side of the car, and the levers for the windshield wipers and turning signals are switched. The prices of the used cars here are incredibly cheap as well! Alex and I bought cars that were USD2,000 or less, a Subaru Impreza and a Daihatsu Mira Gino. Driving around base the first couple of times the only thing going through your mind is “Think left. Think left. Think left.” With practice, you eventually forget what it’s like to drive on the right side of the road with the steering wheel on the left side of the car!

Another aspect people often ask about is food here in Japan. If I’m being honest, my main reservation with coming to Japan was if I was going to find anything that I would like to eat. I’m not an overly picky eater but there are some types of food that are more difficult for me to bring myself to try, such as sushi, octopus and other more exotic seafood varieties. When we arrived in Japan, we had to quarantine on-base for 14 days, so our friends picked up ramen from a restaurant off-base for our first traditional Japanese meal. The ramen was just what I expected it to be; noodles in broth with pork and seasonings. The one thing that surprised me were the two soft boiled eggs that came with the meal; a regular egg and a quail egg. I am not a big fan of soft-boiled eggs, so I let Alex enjoy those for the both of us! Indian and Japanese curry are also popular dishes here, which I wasn’t expecting. Japanese curry is more gravy like and on the sweet side, while Indian curry can be very spicy. A lot of the spice scales go from 1 to 10 and if you pick a 5 you can expect your curry to be VERY spicy. Since being allowed off base we have visited several new cities in Japan and tried many new cuisines.

My favorite memory is from our first weekend off base when we went to the Shibuya area, which is in downtown Tokyo. We were exploring the streets, looking for places to eat or izakayas (bars) to sit at and stumbled upon a restaurant that looked relatively crowded, meaning it was probably going to be good. There was no wait for a table but before we could sit down a waitress informed us that there was no English menu. We all thought “Oh that’ll be no problem at all. We will just use our phones to translate the menu (thank goodness for technology these days).” We sat down at a pretty small table and opened the menu to see that it was HANDWRITTEN, meaning that no matter how hard we tried, our phones weren’t going to be able translate the menu. Unable to see what others were eating, we asked the waitress to bring us her favorite dish and an assortment of dishes. We took pictures of what we ate and after a week or so we found someone who could explain to us what we had for dinner that night. Our meal that night was a traditional one pot dish containing several ingredients that were mostly vegetables, called oden. We supplemented our dinner with some yakitori, which is usually grilled meats on a stick.

Some other foods that we have tried since we have been here are takoyaki (fried octopus balls), okonomiyaki (a pancake dish that includes cabbage, meat, seafood and other toppings), and udon (which is a dish known for its thick noodles). Sushi here in Japan is also very different than sushi in Arkansas. In Arkansas, sushi is served in rolls that contain fish, vegetables, and fruit within them, with bold sauces on top that make them sweet or spicy. In Japan, sushi isn’t sold in rolls at restaurants, though you might find rolls in bento boxes. The sushi is sometimes made with the seaweed on the outside and usually only contains one ingredient, whether it be a fish or pickled vegetable. More commonly, however, it is served as sashimi, which is just a slab of a fish or other meat on top of a small bed of sticky rice. Another big difference, one that always makes me a little wary, is that wasabi is used in a majority of the sushi as a binding agent for the fish, so there’s no need to add more wasabi. In Arkansas, people often mix their wasabi with soy sauce and here in Japan that is a big no-no. We have made an effort to try as many new foods as we can when we travel to different parts of Japan and there is still so much food out there for us to try!

The transition to living in Japan hasn’t always been super easy and I’m learning to go with the flow. Alex can be gone anywhere from a week to a month at a time due to the nature of his job, and those times are, unfortunately, when the bad things decide to occur. I had a bit of a rough start when I moved into our house on base while Alex was gone for a month. Within a week of living in our house, part of the rubber seal around our oven came loose and caught on fire, I had an eye infection pop up, AND I lost the only key I was given for my car. In Japan the cars don’t have a VIN, so it wasn’t just as simple as taking that number to the dealership and having the new key made. Instead I had to figure out how to find a key number located somewhere on the driver side door of my car. I’m sure you can imagine the frustration that came with trying to get a new key for my car in a country where I know little of the language. Nevertheless, three weeks later, I had a new key for my car and I’m so grateful for Alex and all my friends who were kind enough to help in any way they could: offering to lend me their car, figuring out who I needed to contact and helping me laugh off all the frustration.

Many people are also curious about the state of affairs here in Japan in regard to the COVID-19 pandemic. When Alex and I arrived in Japan, vaccinations had just begun so there weren’t many Japanese nationals who were vaccinated yet. However, COVID cases were also fairly low, the Delta variant hadn’t made its appearance yet, so things started to loosen up. Since the pandemic started in 2020, service members and their families were not allowed to visit the Tokyo area and when we arrived, that rule had just recently been removed. Masks were to be worn at all times on-base if you were unvaccinated and those who were vaccinated are to wear masks around Japanese nationals on-base. Everyone was required to wear their mask when they are off the base. In August when the Olympics started, COVID cases began to increase significantly and once again the Tokyo prefecture (region) was off limits. Fortunately for us, Alex and I were able to spend one weekend in Tokyo before restrictions were put in place again. Currently 50% of Japan’s population is fully vaccinated and with the Olympics over, COVID cases are starting to go down again so we are hopeful that soon enough we will be able to go back into Tokyo! One silver lining of being in Japan during this part of the pandemic is that foreign tourists aren’t currently allowed into Japan, so doing touristy things here like going to Universal Studios in Osaka ends up being significantly less crowded. This makes it easier to see all that you want to see in a timely manner! I’m looking forward to when people are allowed back into Japan though so our families and friends can come visit us.

Now back to the big reason for this blog – being a pharmacist in Japan! In January of this year when we were notified that Alex’s next assignment would be in Japan, I was nervous. I was in the middle of my last semester of pharmacy school, I’d be graduating that May and we had to report to Japan by the end of June. That was not a lot of time to take my NAPLEX (pharmacist licensure exam) and get any real experience as a pharmacist. On top of that, I knew I wouldn’t be able to work as a pharmacist in a Japanese pharmacy due to linguistic and regulatory reasons, but I wasn’t sure if I would at least be able to work as a pharmacist in the US military hospital on-base. I did my research, and through talking to friends who were already stationed at the base, I was able to get in touch with the current pharmacist. As it turns out, there weren’t any civilian pharmacist positions. They do, however, accept volunteers! About a month after we got to Japan and were a little more settled in, I secured a job as a nanny on base and started the application process to become a volunteer through the American Red Cross. Once my application is approved, I’ll be able to volunteer in the pharmacy here on-base!

Because we live on a US Air Force base, our pharmacy here runs just like The Pharmacy at Wellington. There are many aspects of the pharmacy here that I have questions about, starting with their inventory. It takes weeks, months even, for packages to make it to us in Japan (I’m still waiting on a package that was shipped out at the end of July). I look forward to getting answers to the many questions in my mind once I’m able to start volunteering in the pharmacy on base, such as: how quickly they are able to have inventory shipments delivered to them, if the shipments come from a warehouse somewhere in Japan or if they come from the United States, and what measures do they have to take to ensure that they have all the medications necessary for people on base, should a need arise?

During my time exploring Japan, I have sought out pharmacies from time to time to compare them to pharmacies back in Arkansas. There are some similarities between the two. These include needing a prescription from a doctor in order to receive a medication and many of the medications are the same but might differ in their brand or generic name. Pharmacies can be found throughout the towns here, but even more abundant than pharmacies are drugstores. Drugstores are essentially convenience stores. Not only are these shops stocked with pharmaceutical products, but they also have daily necessities like toiletries and foodstuffs available to their customers. While you can get prescription medications at every pharmacy in Japan, you can’t always get prescription medications at a drugstore. Drugstores usually have medications that are approved for safe usage and are medications that you would find over the counter in the US, such as cold and flu medications. Sometimes drugstores employ a pharmacist to provide counseling for the over-the-counter medications as well.

Another differing characteristic of pharmacy in Japan is that herbal remedies are still very popular and are usually used as a supplement to modern medicine and in some cases, as a replacement. Medicinal herbs are regulated just like prescription medications and their use is covered by health insurance here in Japan. One of the things I found most interesting while doing some research was that all patients here in Japan carry a prescription record book with them when they visit the pharmacy. A prescription record book, or "okusuri techo," holds information about medicines they’ve taken in the past and any medications they are currently taking. It contains detailed information about the prescriptions, as well as any allergies the patient may have. Each time a prescription is filled, the patient receives a sticker that provides all the information about that medication. This is a very useful tool for pharmacists and patients, especially if patients don’t go to the same pharmacy to fill all their prescriptions.

My time here in Japan has only just begun and there is plenty that I have left to learn. I look forward to being able to practice pharmacy during my time here in Japan, and while I await that opportunity, I am grateful for the perspective I’ve gained and the opportunities I’ve encountered for cultural broadening.

The Power of Plants

Tue, 24 Aug 2021 21:04:47 GMT

August 2021

Plants live in ecosystems just as animals do, so they must also defend themselves against predators and diseases. But unlike animals which can move away from danger, plants rely heavily on chemical weapons. We discovered some fascinating ways in which they do this and we're excited to share this with you!

Some plants attract allies that help them fight off predators. The acacia plant of Central America is known to have a symbiotic relationship with ants: the plant provides nectar and hollow thorns that can be used as nests and the ants protect their home against predators. A bacteria that colonizes the ants also inhibit pathogen growth on the acacia leaves. But the relationship goes deeper -- scientists have discovered an enzyme in the nectar of acacia trees that makes ants chemically dependent on their sugar, to the extent that they are unable to digest other sources of sugar. The tree's manipulation ensures that the ants are driven to defend it, since it is their only food source!

Other plants attract the enemies of their enemies. For example, some corn, cotton, and tobacco plants emit chemical compounds into the air, volatiles, when caterpillars eat their leaves. The volatiles are actually specific to the caterpillar pest attacking the plant, so they attract specific parastic wasp species (some wasps are very particular about which caterpillars they'll choose). The wasps lay their eggs inside the caterpillars, killing them. Wild tobacco uses a different approach to this method: it produces a sweet treat on its stems and leaves that scientists call the "evil lollipop" because it gives leaf-eating caterpillars a bad case of body odor. This smell lets lizards on the ground below the plant know that the caterpillars are available for an easy meal.

Yet other plants use a direct attack method by producing substances that are harmful for its predators. Tobacco plants, for example, produce nicotine which kills insects and has moderate to high toxicity for vertebrates. Caffeine, produced by coffee and tea plants, can paralyze and kill insects that eat their leaves. Another example: the neem tree, which grows in tropical India and Asia, protects itself from a variety of pests by producing approximately 25 compounds that repel insects and / or that disrupt their growth and reproduction.

Our curiousity led us to ask the question: do the fruits and vegetables that we eat contain compounds that protect plants too? The answer is YES!

Plants produce phytochemicals that protect them against viruses, bacteria, and fungi or other dangers, and for us, these same phytochemicals may act as antioxidants, nutrient protectors, prevent cancer-causing agents from forming, or give us relief from ailments.

Beta carotene, for example, helps plants to capture solar energy and prevents too much energy from harming their cells. For us, once eaten, it helps us to synthesize Vitamin A, which is required for sight. Lignins, found in flax seed and whole grain products, makes plant cell walls stronger, helps to transport minerals in plants, and is an important barrier that protects plants against insects and pathogens. For us, lignins are an antioxidant, and antioxidants may help protect our cells from damage caused by free radicals, which are produced by our body when we break down food or are exposed to tobacco smoke or radiation.

Incidentally, vitamins C and E and carotenoids are also antioxidants and you guessed it, they are found in tomatoes, parsley, citrus fruit, brussel sprouts, spinach, nuts, seeds, etc. And so it follows that a balanced diet that includes fruits and vegetables promotes good health. It's not just the vegetarians and vegans who can benefit from a plant-rich diet!

References and Resources:

https://www.sciencedaily.com/releases/2014/01/140115113243.htm
https://www.nationalgeographic.com/animals/article/131106-ants-tree-acacia-food-mutualism
https://agresearchmag.ars.usda.gov/1998/oct/sos/
https://www.cbc.ca/kidscbc2/the-feed/the-secret-world-of-plants
https://www.sciencedirect.com/science/article/pii/B9781483227382500125
https://blogs.scientificamerican.com/scicurious-brain/plants-give-bees-a-caffeine-buzz/
https://www.ncbi.nlm.nih.gov/books/NBK234643/
https://stanfordhealthcare.org/medical-clinics/cancer-nutrition-services/reducing-cancer-risk/phytochemicals.html
https://blogs.scientificamerican.com/guest-blog/phytochemical-pharmacy-the-healing-potential-of-plants/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5855557/
https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/multimedia/antioxidants/sls-20076428
https://stanfordhealthcare.org/medical-clinics/cancer-nutrition-services/reducing-cancer-risk/phytochemicals.html

No Sweat! ... despite the heat...

Thu, 29 Jul 2021 02:09:56 GMT

July 2021

We were surprised to learn that scientists only discovered the cause of smelly armpits last year, in July 2020!

The University of York (UK), in collaboration with Unilever R&D (Bedford, UK), identified a unique enzyme responsible for the production of molecules that cause armpit body odor (BO). Their research also determined that BO is not a modern problem but may have existed prior to Homo sapiens.

Researchers knew that Staphylococcus hominis , bacteria that is part of the human armpit microbiome, eats an odorless compound (Cys-Gly-3M3SH) produced by human sweat glands and that it releases foul-smelling thioalcohol (3M3SH) as a byproduct. But how exactly S. hominis carries out this conversion was unknown until last year.

To find out more, the team delved inside S. hominis to learn how it makes thioalcohols. They discovered an enzyme (called C-T lyase) that converts Cys-Gly-3M3SH to 3M3SH. They then identified the gene in S. hominis that codes for the enzyme and they inserted it into another armpit resident which reportedly does not produce any odor, Staphylococcus aureus . Result: BO was made by S. aureus -- which meant that they had found the culprit enzyme!

University of York co-author Dr. Michelle Rudden commented: “Solving the structure of this ‘BO enzyme’ has allowed us to pinpoint the molecular step inside certain bacteria that makes the odor molecules. This is a key advancement in understanding how body odor works and will enable the development of targeted inhibitors that stop BO production at source without disrupting the armpit microbiome.”

Unilever co-author Dr. Gordon James said: "This research was a real eye-opener. It was fascinating to discover that a key odor-forming enzyme exists in only a select few armpit bacteria —and evolved there tens of millions of years ago."

“All we can say is this is not a new process. BO was definitely around while humans were evolving,” co-author Professor Gavin Thomas from the University of York told The Guardian (newspaper in the UK). “It’s not impossible to imagine these were important in the evolution of humans. Before we started using deodorants and antiperspirants, in the last 50 to 100 years, everyone definitely smelled.”

We’ve heard that perfumes were used extensively in 15 ^th century Europe by royalty and the upper class, when personal sanitary practices of the day did not keep up with an increased aversion to the scent of BO. Fast forward to today, where we appreciate modern perfumery and rely on science. Our knowledge of chemistry and biology allows us to combat BO in two ways: anti-perspirants and deodorants.

Anti-perspirants contain aluminium-based compounds that temporarily block sweat pores. Without sweat, the bacteria in our armpit microbiome does not survive well. Some anti-perspirants also contain fragrants.

Deodorants, usually alcohol based, work by making the armpit region too acidic or salty for the bacteria that usually live there, thereby eliminating odor but not perspiration. Deodorants may also contain perfumes.

To note, humans have two types of sweat glands, the eccrine sweat glands and the apocrine sweat glands. The eccrine glands regulate body temperature – when internal temperature rises, the eccrine glands secrete odorless water to the skin surface, where heat is removed by evaporation. Our apocrine glands, on the other hand, are associated with hair follicles and they secrete a fatty sweat into the gland tubule. Emotional stress causes the tubule wall to contract, expelling the fatty secretion onto the skin, where S. hominis and other bacteria live.

In humans, the apocrine sweat glands are concentrated in the underarm and in genital regions. These glands are inactive until they are stimulated by hormonal changes in puberty.

So, for those of you needing a BO solution, we carry multiple options at The Pharmacy at Wellington:

Traditional anti-perspirants
Traditional deodorants
An effective deodorant made of a proprietary combination of natural herbs and essential oils, hypo-allergenic and suitable for delicate skin
A foot deodorant cream that is alcohol and paraben free, suitable for sensitive skin, and that works (one of our pharmacists' son vouches for this -- his feet don’t stink anymore!)

Ask to have one of these products included in your bag when you check out at our drive-thru!

References and Resources:

https://www.nature.com/articles/s41598-020-68860-z
https://www.york.ac.uk/news-and-events/news/2020/research/enzyme-body-odour/
https://www.biotechniques.com/biochemistry/working-up-a-sweat-key-enzyme-responsible-for-body-odor-identified/
file:///Users/AH/Downloads/2020-07-life-pits-scientists-key-enzyme.pdf
https://www.theguardian.com/science/2020/jul/27/know-sweat-scientists-solve-mystery-behind-body-odour
https://www.sciencemag.org/news/2020/07/scientists-discover-secret-behind-bad-body-odor
https://meaww.com/scientists-bacteria-pungent-body-odor-humans-stinky-armpit-deodorant-study-university-of-york
https://www.derryjournal.com/health/scientists-have-discovered-exactly-what-causes-body-odour-2926092
https://en.wikipedia.org/wiki/History_of_perfume
https://www.britannica.com/science/sweat-gland#ref146359
https://www.mayoclinic.org/diseases-conditions/sweating-and-body-odor/diagnosis-treatment/drc-20353898

The Pharmacy at Wellington's Temporary COVID-19 Vaccine Clinic

Mon, 28 Jun 2021 00:07:50 GMT

June 2021

Temporary COVID-19 Vaccine Clinic Closed, Vaccines Given at The Pharmacy

Your emails and messages have touched our hearts and we thank you for taking the time to let us (or others via Google maps or Facebook) know about your experience. With renewed enthusiasm and continued focus, we are now providing COVID-19 vaccines at our pharmacy location.

Our temporary vaccine clinic is closed due to a drop-off in the demand for COVID-19 vaccines. We are hopeful that interest in getting vaccinated against COVID-19 will increase, so that it may be re-opened to serve the Little Rock and surrounding areas. As many of you may be aware:

Healthcare workers and scientists are just beginning to gather data on "long covid", which are ongoing health problems that people can experience more than four weeks after being first infected. This includes people who did not have symptoms when first infected.

Laboratory studies suggest specific monoclonal antibody treatments may be less effective for treating cases of COVID-19 caused by certain variants.

In addition to the variants Alpha (B.1.1.7, first identified in the UK), Beta (B.1.351, first identified in South Africa), Gamma (P.1, first identified in Brazil), and Delta (B.1.617.2, first identified in India), now there is a Delta Plus variant (AY.1, identified in Europe).

The CDC and FDA are considering the possibility of extending eligibility for the Pfizer-BioNTech vaccine to children aged 5 to 11.

The vaccines that we currently administer are expected to provide at least some protection against new virus variants because they elicit a broad immune response involving a range of antibodies and cells. Therefore, changes or mutations in the virus should not make vaccines completely ineffective. In the event that any of these vaccines prove to be less effective against one or more variants, it will be possible to change the composition of the vaccines to protect against these variants.

The pandemic isn't over until it's over.

Let's continue to do our part, per current recommendations from the WHO (World Health Organization):

References and Resources:

https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects.html
https://www.cdc.gov/coronavirus/2019-ncov/variants/variant-info.html
https://www.bbc.com/news/world-asia-india-57564560
https://economictimes.indiatimes.com/news/et-explains/delta-plus-key-things-to-know-about-new-coronavirus-variant-in-india/articleshow/83739996.cms?from=mdr
https://www.who.int/news-room/feature-stories/detail/the-effects-of-virus-variants-on-covid-19-vaccines?gclid=EAIaIQobChMItrLmuv2z8QIVSGpvBB3lQAmLEAAYASAAEgLhH_D_BwE

Not All Vaccines Are Created Equal

Wed, 05 May 2021 22:05:12 GMT

May 2021, updated October 2023

Vaccine Technologies

Vaccines that have been developed to help protect us from various illnesses are based on several different technologies:

Inactivated vaccines - they use the killed version of the germ that causes a disease.
Live-attenuated vaccines - they use a weakened (or attenuated) form of the germ that causes a disease.
Subunit, recombinant, polysaccharide, and conjugate vaccines - they use specific pieces of the germ, like its protein, sugar, or capsid (a casing around the germ).
Toxoid vaccines - they use a toxin made by the germ that causes a disease.
Viral vector vaccines - they use a modified version of a different virus as a vector to deliver protection.
mRNA vaccines - they provide instructions for our cells to make proteins to be able to train our immune system. mRNA is a type of RNA (ribonucleic acid).

We thought that it might be useful to provide information about the mRNA technology in particular, as it may not be as well known as the older technologies, and of course because both the Pfizer-BioNTech and Moderna vaccines against COVID-19 are based on mRNA technology.

How long has mRNA technology been studied?

The story starts in the 1970's in what was then the Hungarian People's Republic. There, Katalin Karikó, today 66 years old, began her career as a biochemist, and she soon became interested in RNA-based therapy. Upon receiving an invitation from Temple University in Philadephia, she and her husband sold their car and stuffed the money, the equivalent of about $1,200, in their two-year-old daughter's teddy bear and emigrated to the United States. By 1990, Karikó was on track to full professorship at the University of Pennsylvania's School of Medicine.

Her research centered around designing mRNA that could tell cells which proteins to make. The possibilities were promising: antibodies against infection, enzymes to reverse a rare disease, growth agents to mend damaged heart tissue, etc. The problem, Karikó knew, was that synthetic RNA was notoriously vulnerable to the body's natural defenses, so it would likely be destroyed before reaching its target cells. As well, triggering such an immune response might make mRNA therapy a health risk for some patients. At that time, Karikó worked on mRNA therapy for cerebral diseases and strokes.

Karikó tirelessly sought funding to support her research. As she says, "Every night I was working: grant, grant, grant. And it came back always no, no, no." This resulted in a demotion at UPenn at a particularly difficult time in her life, amidst a cancer diagnosis and her husband being stuck in Hungary to sort out a visa issue. Karikó didn't give up though, "I tried to imagine: Everything is here, and I just have to do better experiments." (To note, it isn't surprising that Karikó's daughter, Susan Francia, is a two-time Olympic gold medalist in rowing.)

One day at a photocopier at UPenn, Karikó met colleague Drew Weissman as they sympathized over the lack of funding for RNA research. Weissman, professor of immunology studying vaccines, began collaborating with Karikó, who changed her focus to RNA-based vaccines. The problem of the body fighting synthetic RNA continued to be the challenge, but in 2005, Karikó and Weissman had a breakthrough and discovered a way for synthetic mRNA to do its job while triggering only a reduced immune response.

Fast forward to today, where two of the vaccines used against COVID-19 are based on mRNA technology: those of Moderna and Pfizer-BioNTech. Karikó, now a Senior Vice-President at BioNTech RNA Pharmaceuticals and an Adjunct Professor at The University of Pennsylvania, says, "Really, we will celebrate when this human suffering is over, when the hardship and all of this terrible time will end, ... And then I will be really celebrating."

We can all help to make that happen earlier by getting vaccinated.

For those of you interested in continuing to read the story of how Moderna and Pfizer-BioNTech ended up licensing the mRNA technology and producing vaccines, please refer to the first link under "References and Resources" below.

Courtesy Katalin Karikó

What is mRNA?

Let's start with the genome, which is an organism's complete set of genes and genetic instructions needed to make that organism. The genetic instructions are encoded in the DNA that is stored in the nucleus of nearly every cell in our body. These cells contain all the DNA, but, for example, for a skin cell to be a skin cell and not a heart cell, a skin cell only follows the set of instructions in our genome related to skin cells.

We can think of the genome as the reference section of a library where books can't be checked out. If a skin cell needs instructions on how to do something, it sends certain proteins to the library (in the nucleus of the cell) to read the book (the DNA) and take notes of the specific instructions for the task. These notes, or mRNA, are then carried to another part of the cell where they are used to build proteins, and proteins are required for the structure, function, and regulation of the body's tissues and organs. mRNAs are timed to self-destruct -- within minutes for certain proteins that need to be tightly controlled, or up to a few hours for others.

Every protein that a cell makes goes through this process. DNA is copied (transcribed) into mRNA and mRNA is translated into proteins.

How do mRNA vaccines work?

The goal of a vaccine is to get our immune system to react to a harmless version or part of a germ so that when we encounter the real thing, we're ready to fight it off.

mRNA vaccines contain instructions to make a harmless version of a protein of SARS-CoV-2 (the virus that causes COVID-19), the spike protein. This is the protein that the virus uses to bind with and get into our cells. When we get a dose of the mRNA vaccine, our body treats the mRNA instructions as if they came from its own cells and produces a harmless version of the spike protein (not the whole virus).

Our immune system recognizes the harmless spike protein as an invader and makes antibodies to fight it off. In the meantime, the mRNA in the vaccine is soon destroyed by our cells, just as any other mRNA would be. Later, if we are exposed to the virus, our trained immune system recognizes the spikes in SARS-CoV-2 and knows how to fight off the real virus.

Thus, the risk of infection and the risk of severe illness are reduced, and we are protected.

Why is mRNA vaccine technology so promising?

For one, speed. On January 11, 2020, Chinese researchers published the genetic sequence of the virus. Within about 48 hours, Moderna's mRNA vaccine recipe was finalized, and by late February, batches of the vaccine had been shipped to Bethseda, Maryland, for clinical trials. The rapid timeframe is in part due to the fact that RNA vaccines are produced chemically rather than by biological processes, so scientists know the exact composition of these vaccines. To note, the ingredients are listed in the respective Fact Sheets for the Pfizer-BioNTech and the Moderna vaccines (both available on the CDC website, at the last two links in the References and Resources section below). This speed can help scientists to develop new mRNA vaccines to combat variants of SARS-CoV-2.

BioNTech (and Neon Therapeutics, a company in Boston that BioNTech has acquired) are leaders in individualized cancer immunotherapy. They have been working on therapeutic vaccines against prostate, breast, and pancreatic cancer. Moderna has also been working on therapeutic vaccines, for ovarian cancer, lymphoma cancer, and solid tumors. The cancer genome contains about six billion letters and is very complex. By comparison, the SARS-COV-2 genome has 30,000 letters and a few variants. Therapeutic vaccines for cancer have been shown to be innocuous and scientists and researchers continue to work on their effectiveness.

Another advantage of mRNA vaccines is that they can deliver instructions to specific, targeted cells. This technology could potentially be used, for example, for genetic diseases where only one protein is missing from the body (caused by a gene mutation). Many single gene disorders are rare, but together, they affect millions of Americans. Some of the more common single gene disorders include: cystic fibrosis, hemochromatosis, and sickle cell anemia.

Proponents of mRNA vaccines recognize that they are not necessarily the "holy grail" of vaccines, but we all recognize their immense potential.

We also know that vaccines, no matter how advanced, safe, and effective, can only help if people get vaccinated. Let's each do our part to help end the COVID-19 pandemic.

Update as of October 2, 2023

Katalin Karikó and Drew Weissman were jointly awarded the 2023 Nobel Prize in Physiology or Medicine for their discoveries concerning nucleoside base modifications that enabled the development of effective mRNA vaccines against COVID-19.

Per the Nobel Prize website:

"The discoveries by the two Nobel Laureates were critical for developing effective mRNA vaccines against COVID-19 during the pandemic that began in early 2020. Through their groundbreaking findings, which have fundamentally changed our understanding of how mRNA interacts with our immune system, the laureates contributed to the unprecedented rate of vaccine development during one of the greatest threats to human health in modern times."

References and Resources:

https://www.hhs.gov/immunization/basics/types/index.html
https://www.statnews.com/2020/11/10/the-story-of-mrna-how-a-once-dismissed-idea-became-a-leading-technology-in-the-covid-vaccine-race/
https://www.cnn.com/2020/12/16/us/katalin-kariko-covid-19-vaccine-scientist-trnd/index.html
https://www.vaccines.gov/basics/types - types of vaccines
https://phys.org/news/2021-04-mrna-key-ingredient-covid-vaccines.html
https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different-vaccines/mRNA.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fvaccines%2Fcovid-19%2Fhcp%2Fmrna-vaccine-basics.html
https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different-vaccines/mrna.html
https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different-vaccines/how-they-work.html#:~:text=Vector%20vaccines%20contain%20a%20weakened,is%20called%20a%20viral%20vector
https://news.ncsu.edu/2020/12/vaccines-koci-101/
https://www.cdc.gov/coronavirus/2019-ncov/downloads/vaccines/COVID-19-mRNA-infographic_G_508.pdf
https://ici.radio-canada.ca/ohdio/premiere/emissions/les-annees-lumiere/segments/entrevue/347203/arn-messager-vaccins-potentiel-lal
https://www.modernatx.com/
https://biontech.de/science/platforms
https://en.wikipedia.org/wiki/BioNTech
https://en.wikipedia.org/wiki/Katalin_Karik%C3%B3
https://en.wikipedia.org/wiki/Drew_Weissman
https://www.sciencedirect.com/science/article/pii/S0960982215006065
https://www.ncbi.nlm.nih.gov/books/NBK132154/
https://news.ncsu.edu/2020/12/vaccines-koci-101/
https://www.health.harvard.edu/blog/why-are-mrna-vaccines-so-exciting-2020121021599
https://www.theatlantic.com/ideas/archive/2021/03/how-mrna-technology-could-change-world/618431/
https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different-vaccines/Pfizer-BioNTech.html
https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different-vaccines/Moderna.html
https://www.nobelprize.org/prizes/medicine/2023/press-release/

Back to Basics: Nutrition

Sun, 31 Jan 2021 23:53:13 GMT

January 2021

"You are what you eat"

As the adage goes. It makes sense since food and liquids provide our bodies with the necessary vitamins, minerals, fiber, water, and energy to maintain health. Our digestive system breaks down nutrients so that they can be carried via the bloodstream to all the cells that need them. So it follows that nutrition and health are closely linked.

Many of us have been exposed to good information about having a healthy diet. We know that we should eat more fruits and vegetables, cook more often, eat less red meat, avoid fast food, avoid sweet or salty processed snacks, etc. But really, it is not always easy to put the advice to practice, so we thought that we could share 5 tips that work for us, your co-owner pharmacists here at The Pharmacy at Wellington.

Please note that your specific situation may be different from ours. Before making major changes to your diet, you should consult your doctor. As pharmacists, we can also advise you on food and medication interactions.

Tip #1: Listen to my body

Our bodies do better with an eating routine ajusted to our lifestyle and schedule, rather than inconsistent mealtimes from day to day. Some people prefer three meals a day, while others prefer to eat more frequently throughout the day. We try keeping to our own routines since skipping meals can lead to overeating later.

Have some ready-to-eat fruit, nuts, or other non-processed foods for those moments where we feel like snacking on something.

Use thirst as a signal that our body needs water. In winter, when we don't sweat as much, we try to drink water throughout the day such that our urine is a clear yellow (see the Australian government's urine color chart, link below in the list of References), indicating that we are hydrating sufficiently.

Tip #2: Colorful and in moderation

We both like colorful plates -- they are appetizing! We're not talking about artificial colors, but vibrant red cherry tomotoes, or dark purple eggplant, bright fresh green asparagus, the energetic orange of mandarin oranges, sweet yellow corn, ... and the list of our favorites goes on. The more color, the more variety of vitamins and minerals.

Since we both grew up in families where food is not wasted, we clean our plates. We have learned over the years to fill our plates only with what we can finish because over-eating can be physically uncomfortable.

We know from our training that even good things can become bad for us if taken in excess. Quantity counts, so we stick with "everything in moderation".

Tip #3: Build long-term habits

It's important to us that our kids pick up healthy eating habits from us, and it's not easy since we work long hours. However, we do model healthy food choices and we're both very fortunate to have mothers who are more than happy to help fill the cooking gap for our families.

We have learned that it is impossible to take care of everything ourselves and that we have a great support network around us. This helps us to maintain good eating habits long-term.

Tip #4: Pay attention to the source

Since we tend to snack on what's on the counter or in the fridge, we know that it's better to have nutritious food available rather than junk food, so we're careful about what we buy. This naturally means that we do our best to avoid the snack food, processed food, and candy aisles at the supermarket, we grocery shop on a full stomach, and we try to spend more time in the fruit and vegetable section.

Some of our extended family and friends enjoy going to farmers' markets in the summer and fall and we've been happy beneficiaries of their harvests.

Tip #5: Be patient with ourselves

Those of you who know us know that we hold ourselves to high standards. Of course we're not perfect, and we'll be honest -- sometimes those sweet or salty snacks fulfill a craving. We just don't make it a habit because a) we don't always feel good after having them and b) we know that long term they are not good for us.

Our parents have also told us that it's when we get older that we'll feel the effects of how we treated our bodies in our younger years, and we know that is true. We also know that it's never too late to start (or to restart with) healthy food and beverage choices, because our bodies are resilient and adapt quickly.

If there's one thing we're learning from this pandemic, it's that many other things are secondary to good health!

Let us know how you make healthy food choices -- or let us know if you have any questions about interactions between your prescriptions or OTC (over-the-counter) medications and food and beverages.

Your local partners in health,

Brittany and Nick

References and Resources:

Mayo Clinic on nutrition -- https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/basics/nutrition-basics/hlv-20049477
Berkeley Health on puffed snacks -- https://www.berkeleywellness.com/healthy-eating/nutrition/article/puffed-snacks-healthier-option
Johns Hopkins University on diet and health -- http://www.foodsystemprimer.org/food-and-nutrition/diet-and-health/
Dietary Guidelines for Americans, 2020-2025 -- https://health.gov/news/202012/usda-and-hhs-just-released-dietary-guidelines-americans-2020
Australian Government urine colour chart -- https://www.healthdirect.gov.au/urine-colour-chart

Thank You The Pharmacy at Wellington Team!

Thu, 31 Dec 2020 02:54:46 GMT

December 2020

We thank each of you, whether your stay with us was long, short, or is ongoing -- we appreciate the contributions you've made!

As we fondly recall the good memories we've created together, we share a few behind-the-scenes photos here:

We look forward to working with you in 2021 and beyond -- together we make a great team!

Put Your Best Feet Forward

Sun, 29 Nov 2020 13:37:41 GMT

November 2020

Image credit: Pixabay

Ugh, nothing's right!

As temperatures drop, we're reminded that having uncomfortable feet can make some of us miserable and can even change our mood and make us irritable, or affect our productivity or sleep.

Fortunately, we can take preventive meaures and as they say, "prevention is better than a cure". So here are some tips for putting your best foot forward! ��

Looking after your feet

Maintain excellent hygiene -- Wash your feet daily with warm, soapy water. After rinsing well, dry your feet completely, including in between the toes.

Check your feet regularly -- for cuts, sores, redness, swelling, or bruising. Get to know what's normal.

Care for the skin on your feet -- apply moisturizer before going to bed if your skin is dry, to prevent it from cracking and to improve its texture. File dry or hard skin using a foot file or pumice stone.

Trim toenails regularly -- straight across, instead of rounding them at the edges, to prevent ingrown toenails.

Alternate your footwear and change socks daily -- especially after activities that cause sweating. This helps to prevent damp conditions, which bacteria and fungi love.

Wear well-fitted and appropriate shoes for the activity -- to prevent corns, calluses, ingrown toenails, foot pain, foot deformities, etc.. To note, shoe size may change due to:

age - tendons relax and feet may widen
certain medical conditions and medications - that cause water retention may cause foot swelling
certain hormones during pregnancy - may cause an increase in shoe size

Don't wear high heals every day -- this might not be relevant during a pandemic, but wearing high heels every day can limit the flexion of the foot and ankle and cause more serious problems.

Lead a healthy lifestyle -- and do foot stretches (see the first reference link below for ideas). Maintain a healthy weight and refrain from smoking or having excess alcohol.

Don't ignore a foot problem -- seek medical attention promptly.

If you have diabetes, ensure that your regular doctor visits include a review of your feet.

What are common foot conditions that we can help with at The Pharmacy at Wellington?

Excess sweating and/or odor
Certain nail problems
Warts
Blisters
Corns and calluses
Athlete's foot
Cracked heels

What are common foot problems that you should see your doctor about?

Changes in your feet and you have diabetes, arthritis, a circulatory disease, a neurological condition, or are immunosuppressed.
Bunions
Stress fractures
Ingrown toenails

Caring for Children's Feet

Image credit: Mufid Majnun on Unsplash

Caring for babies' feet:

Allow free movement -- babies develop muscles by kicking and wriggling and feet need to be free and active.
Make sure foot coverings fit properly because babies grow quickly -- pay special attention to combination stretch suits with covered toes. Also, ankle ties of booties should be loose enough to allow good blood circulation.
Keep babies' feet clean and nails well manicured -- and dry thoroughly, especially in between toes, after washing daily. As with adult toenails, trim straight across rather than rounding at the edges.

When children start to walk:

Continue to maintain good foot hygiene and also:

Observe your child's gait and seek medical advice if:
toes turn out a lot
one foot turns in or out much more than the other
walking doesn't start by 18 months
if your child has "knock knees"
if your child displays significant toeing in.

Choose the right shoes
have your child's feet measured when buying shoes to ensure the right length, breadth, and depth. Shoes should be lightweight, flexible, and fit securely onto feet. They should be comfortable around the heel and not too loose or too tight.
avoid shoes made from synthetic materials as children's feet perspire.
check shoes regualrly to ensure that there is a 1 cm space between the longest toe and the end of the shoe.

Many conditions can be corrected if identified and addressed early enough. Just as for adults, "prevention is better than a cure".

We're available and happy to help -- just call us at 501-708-4320.

Your local partners in health,

Brittany, Nick, and the whole team

References and Resources:

Harvard Women's Health Watch on tips for not neglecting your feet: https://www.health.harvard.edu/staying-healthy/dont-forget-your-feet
Harvard Health on causes of cold feet: https://www.health.harvard.edu/diseases-and-conditions/causes-of-cold-feet
University of Utah Health on wearing high heels: https://healthcare.utah.edu/the-scope/shows.php?shows=0_yg0o2jx3
Very Well Health (partner of Cleveland Clinic) on wearing the right shoe size: https://www.verywellhealth.com/do-people-wear-correct-size-shoes-1337769
University of California Berkeley Wellness on healing cracked heels: https://www.berkeleywellness.com/self-care/home-remedies/article/healing-cracked-heels
Mayo Clinic on stress fractures: https://www.mayoclinic.org/diseases-conditions/stress-fractures/symptoms-causes/syc-20354057
Australian government's HealthDirect on foot care for children: https://www.healthdirect.gov.au/childrens-feet
American College of Foot and Ankle Surgeons on 5 signs your child may have foot problems: https://www.foothealthfacts.org/article/five-signs-your-child-may-have-a-foot-problem
Institute for Preventive Foot Health on preventive foot health for children: https://www.ipfh.org/foot-care-essentials/preventive-foot-health-for-children
British National Health Institute on foot care: https://www.nhsinform.scot/healthy-living/preventing-falls/keeping-well/looking-after-your-feet
Royal Pharmaceutical Society of Great Britain's Pharmaceutical Journal on common foot conditions: https://www.pharmaceutical-journal.com/cpd-and-learning/learning-article/management-and-treatment-options-for-common-foot-conditions/20203233.article?firstPass=false

COVID-19 Tests at The Pharmacy at Wellington

Tue, 20 Oct 2020 20:44:38 GMT

October 2020

Image credit: the Center for Disease Control (CDC)

What are the different COVID-19 tests and which one should I get?

Please keep in mind that COVID-19 is a new disease (it is indeed a novel coronavirus) so information about tests for it is continually evolving. Below is a summary of what is currently known.

Why is testing important?

Early identification of people currently with COVID-19 and people who have had the virus is key for:

Early monitoring and early treatment to help prevent complications, especially for high-risk individuals;
Early isolation, to prevent spread;
Contact tracing so those exposed can self isolate, again to prevent spread;
Public health officials to understand the prevalence, spread, and contagiousness of the disease, so that mitigation efforts and caseload planning can be more effective; and
Data gathering by researchers in their efforts to better understand the virus as quickly as possible, in order to develop medicines, vaccines, etc., to save lives.

What kinds of tests are there?

Diagnostic tests available to determine if a person is currently infected:

Molecular tests
Also called PCR tests, viral RNA tests, nucleic acid tests
Antigen tests
Antigens are substances that cause an immune response in the body. An immune response can be, for example, the production of antibodies.

Tests available to see if a person has been infected in the past:

Antibody tests
Also called serologic tests, blood tests
Antibodies are an immunoglobulin and are made by specialized white blood cells to identify and neutralize foreign substances in the body.

Generally speaking, the true accuracy of COVID-19 tests is unknown due to the following, amongst other possible reasons:

False negatives and false positives can occur.
How carefully a specimen is collected and stored may affect accuracy.
The Federal Drug Agency (FDA) has granted emergency use authorization for COVID-19 testing, which means that the usual vigorous testing and vetting hasn't necessarily taken place as it would ordinarily.
A large and growing number of companies and laboratories offer COVID-19 tests so accuracy may vary.
These tests are new and without a long track record; assessments of accuracy can only be approximate.

However, when tests are used to screen for a disease, two measures are used to determine how valid a test is: sensitivity and specificity.

Sensitivity is the ability of a test to correctly identify patients with a disease.
Specificity is the ability of a test to correctly identify patients without the disease.

Here's an illustrative example (scroll to the right to see all 5 columns of this table):

Image credit: Mufid Majnun on Unsplash

Molecular or PCR Tests

How is the test done?

Fluid is collected using a nasal swab, throat swab, or from saliva.

How long does it take to get results?

If analyzed on-site, results can be obtained within minutes, but generally samples are shipped to a laboratory and results take several days.

What does the test look for?

Viral RNA, or the genetic material of the SARS-CoV-2 virus, using a technique called polymerase chain reaction (PCR).

How about accuracy?

Often referred to as the "gold-standard" test, molecular tests are currently more accurate than antigen tests. However, molecular tests are also more expensive than antigen tests. Molecular tests typically do not need to be repeated for accuracy.

Antigen Tests

How is the test done?

Fluid is collected using a nasal or throat swab.

How long does it take to get results?

Results are usually available within 15 minutes to an hour.

What does the test look for?

The presence of certain proteins on the surface of the virus, present in the fluid sample collected.

How about accuracy?

Positive results are considered very accurate. However, there is an increased chance of false-negative results — meaning it is possible to be infected with the virus but have a negative result. The recommended timing for getting an antigen test is at the onset of symptoms (when the virus is actively replicating), or 5 days after the date of exposure to a COVID-19 positive patient (see below, "who should get a diagnostic test?"). Depending on the situation, a molecular test may be recommended to confirm a negative antigen test result.

Who should get a diagnostic test?

A) If you develop any symptoms of COVID-19, even if they are mild, you should get tested. Symptoms may appear 2-14 days after exposure to the virus and may include:

Fever, chills, or shaking chills
Signs of lower respiratory illness (cough, shortness of breath, lowered oxygen saturation)
Fatigue, sore throat, headache, body aches/myalgia, or new loss of sense of taste or smell
Other less common symptoms can include gastrointestinal symptoms (nausea, vomiting, diarrhea), rash, and inflammatory conditions such as "COVID toes".

B) If you are a close contact of someone who is symptomatic or who has tested positive for COVID-19:

If you were within 6 feet of them for at least 10-15 minutes, while they were symptomatic or within the 48 hours before symptom onset, OR
If you were within 6 feet for at least 10-15 minutes of someone who tested positive in the 48 hours before their test was taken or anytime in the 10 days after their test.

If either scenarios A) or B) apply to you, it would be prudent for you to consider getting a diagnostic test.

Antibody Tests

How is the test done?

Finger stick or blood draw.

How long does it take to get results?

Results may be known the same day or within 3 days.

What does the test look for?

The presence of antibodies. To note, it generally takes one to two weeks for our bodies to produce antibodies after an infection, so getting an antibody test too soon may result in a false negative. There is also currently no evidence that a positive antibody test means that a person is immune from COVID-19.

How about accuracy?

Accuracy depends on the presence of antibodies, which may depend on the strength of a person's antibody response, which in turn is dependant upon age, nutritional status, severity of the disease, medications, etc. Sometimes a second antibody test is needed for accurate results.

While people are grappling with so many different tests and the world is understandably impatient for a vaccine against SARS-CoV-2, if we step back and put things in perspective a bit, scientists have been researching influenza since the 1930's and continue to make new discoveries about that virus today. Granted, science and technology have advanced tremendously since the 1930's, but sometimes it just takes time for biological systems to act and react, in order that we may make observations, test, experiment, draw conclusions, etc., and we haven't yet found a way to speed up time!

References and Resources:

American Heart Association - why testing is important: https://www.heart.org/en/news/2020/04/02/covid-19-science-why-testing-is-so-important
FDA - types of COVID-19 tests: https://www.fda.gov/consumers/consumer-updates/coronavirus-testing-basics
CDC - antigen tests: https://www.cdc.gov/coronavirus/2019-ncov/lab/resources/antigen-tests-guidelines.html
Harvard Health - types of testing: https://www.health.harvard.edu/blog/which-test-is-best-for-covid-19-2020081020734
Government of MA on who should get tested: https://www.mass.gov/covid-19-testing
CDC - the differences between the flu and COVID-19: https://www.cdc.gov/flu/symptoms/flu-vs-covid19.htm
CDC - influenza, a prevention timeline: https://www.cdc.gov/flu/pandemic-resources/pandemic-timeline-1930-and-beyond.htm
Mayo Clinic - what to expect from a nasal swab procedure: https://www.mayoclinic.org/tests-procedures/covid-19-diagnostic-test/about/pac-20488900#:~:text=COVID%2D19%20diagnostic%20testing,19%20%E2%80%94%20molecular%20and%20antigen
Nature - what rapid antigen tests can and can't do - https://www.nature.com/articles/d41586-020-02661-2
South Carolina Dept of Health and Environmental Control - symptoms worksheet - https://scdhec.gov/sites/default/files/media/document/CDC-Flyer-14-Day-Monitoring-Worksheet-10.20.2020.pdf
Arkansas Department of Health - what is antibody testing - https://www.healthy.arkansas.gov/images/uploads/pdf/Antibody_Testing_(1).pdf
Chemial & Engineering News, American Chemical Society - how the Quidel Sofia 2 SARS Antigen Test works - https://cen.acs.org/analytical-chemistry/diagnostics/COVID-19-antigen-tests-landed/98/web/2020/06
BMJ Journal, Evidence-Based Nursing - sensitivity and specificity: https://ebn.bmj.com/content/23/1/2
BMJ Journal, Covid-19 laeral flow tests: https://www.bmj.com/content/371/bmj.m4469#

Back to Basics: Water

websites@hibu.com (Hibu Websites) — Sat, 22 Aug 2020 20:10:56 GMT

August 2020

photo credit: Image by Michael Tavrionov from Pixabay

There is no doubt about it, water is essential for human life and health. But let’s dig a little deeper since there's more than meets the eye.

How do our bodies use water?

Our bodies are made up of about 60% water and every cell, tissue, and organ needs water to work properly. For example, water:

Regulates body temperature
Moistens tissues in the eyes, nose, and mouth
Protects organs and tissues
Carries nutrients and oxygen to cells
Lubricates and cushions joints
Protects the spinal cord and other sensitive tissues
Lessens the burden on the kidneys and liver by flushing out waste products through urination, perspiration, and bowel movements
Helps dissolve minerals and nutrients to make them accessible to the body

How much water should I drink every day?

We have all seen various recommendations for how much water we need to drink every day, and it's helpful to keep the guidelines in mind, but we should also be aware that the amount of water each of us needs is dependent on several factors:

Our age and gender -- Older adults may benefit from drinking some water when not thirsty as studies have shown that they don't always sufficiently replenish their body's need for water after fluid deprivation. Men generally need more water than women due to their size / muscle mass.
Our environment -- Hot or humid weather can make us sweat and requires additional fluid intake. Dehydration can also occur at high altitudes.
Physical activity -- If our workout makes us sweat, we should drink water before, during and after exercising to cover the fluid loss. Exercising intensely for over an hour may require us to replace electrolytes (minerals in our blood) lost through sweat by drinking a sports drink, eating an energy bar, or by having certain healthy, whole foods.
Our general health -- If we're running a fever or have diarrhea or vomiting, our bodies will need more water than usual. Other conditions or situations that may require increased fluid intake include bladder infections, urinary tract stones, and taking diuretic medications. We should follow our physician's recommendations.
If we're pregnant or breast-feeding -- Women in both situations require additional fluids to stay hydrated. Again, we should follow our physician's recommendations.

Guidance on how hydrated we are:

Information and image credit to the Australian government: https://www.healthdirect.gov.au/urine-colour-chart

What other sources of fluid are there?

Regular readers of this blog or recipients of our monthly email newsletter will likely know that water isn't our only source of fluid intake, but that we also have the choice of other beverages or foods, for example:

spinach, celery, cabbage, strawberries are 90% to 99% water
ice cream, legumes, chicken breast are 60% to 69% water
bread, cheddar cheese are 30% to 39% water
peanut butter, crackers are 1% to 9% water

What happens if I have too much or too little water?

Symptoms of dehydration (not enough water) may include:

feeling dizzy or lightheaded
feeling tired
feeling thirsty
having a headache
dry mouth, lips, eyes
urinating small amounts of liquid, urinating fewer than 4 times a day
disruptions in mood, cognitive functioning
constipation, small / hard stools

Drinking too much water can lead to a condition called hyponatremia, where the concentration of sodium in the blood is abnormally low. To note, hyponatremia may also be caused by other underlying medical conditions and is not exclusive to drinking too much water. Symptoms may include:

nausea, vomiting
headache
confusion
loss of energy, drowsiness, fatigue
restlessness, irritability
muscle weakness, spasms, cramps
seizures
coma

What's the bottom line?

Preventing dehydration and hyponatremia, drinking sufficient water, and taking in an adequate amount of liquids would be the smart way to go. Here are some tips that we hope will help:

Listen to your body and watch for signs:

Drink water if you're thirsty.
Ensure that you urinate at least 4 times per day.
Pay attention to the color of your urine. (See the last two links in the References and Resources section below.)

Give your body a chance to adapt:

Opt for a gradual increase in physical activity rather than increasing physical effort too aggressively or too quickly.
Acclimitize yourself gradually to new environments, especially hot / humid ones, before exercising strenuously in them.

Drink water as part of a healthy lifestyle:

Ensure you replenish electrolytes by eating whole, unprocessed foods where possible. (See the article in Runners World in the References and Resources section below.)
Add lemon, lime, strawberries, other fruit, or herbs to water if you prefer that to plain water. Choose water instead of sugar-sweetened beverages.
Store some bottles of water in the freezer so that you can grab them on the go to enjoy cold. Keep in mind that you might want to remove the lid and a bit of water before leaving water bottles in the freezer because water expands as it freezes. Simply replace the lid after the water has frozen.
Have plenty of whole fruits and vegetables every day.

Would you like to be notified of new blog entries? Simply sign up for our e-newsletter here : https://mailchi.mp/db333abf3867/e-newsletter_from_aug2020_blog

Your local partners in health,

Brittany, Nick, and the team

References and Resources:

Mayo Clinic on what the body does with water: https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/water-essential-to-your-body
National Center for Biotechnology Information (NCBI) of the U.S. National Institutes of Health (NIH) on water intake of infants vs adults and the contribution of drinking water to mineral nutrition: https://www.ncbi.nlm.nih.gov/books/NBK216589/
Runners World on how to replace electrolytes with whole foods: https://www.runnersworld.com/nutrition-weight-loss/a20795183/the-best-foods-to-replenish-electrolytes/
Mayo Clinic on types of diuretics: https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/diuretics/art-20048129
Stanford Medicine on electrolyte supplements: https://med.stanford.edu/news/all-news/2020/02/electrolyte-supplements-dont-prevent-illness-in-athletes.html
BBC on drinking water for better skin: https://www.bbc.com/future/article/20120903-is-drinking-water-good-for-skin
CDC on water and nutrition: https://www.cdc.gov/healthywater/drinking/nutrition/index.html
NCBI re a study on Water, Hydration, and Health: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2908954/
National Health Service (NHS) of the UK, on dehydration: https://www.nhs.uk/conditions/dehydration/
British Journal of Nutrition on a study about hydration and mood and cognition: https://www.researchgate.net/publication/259988117_Effects_of_hydration_status_on_cognitive_performance_and_mood
Mayo Clinic on how much water to drink: https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/water/art-20044256
Mayo Clinic on dehydration: https://www.mayoclinic.org/diseases-conditions/dehydration/diagnosis-treatment/drc-20354092
Mayo Clinic on hyponatremia: https://www.mayoclinic.org/diseases-conditions/hyponatremia/symptoms-causes/syc-20373711
University of California San Diego Health on the color of urine: https://health.ucsd.edu/news/features/pages/2014-04-21-colors-that-suggest-urine-trouble.aspx
Australian Department of Health, urine colour chart: https://www.healthdirect.gov.au/urine-colour-chart

Nick on Being a Pharmacist Dad

websites@hibu.com (Hibu Websites) — Fri, 10 Jul 2020 20:49:20 GMT

July 2020

I’ve been asked what it’s like to be a pharmacist dad so I thought I’d share my experience, which will of course be different from what other pharmacist dads experience.

Does being a parent and a pharmacist make a difference in your home and professional lives?

Yes, absolutely. I apply my professional knowledge and experience at home and vice versa. For example, when one of my kids had croup (inflammation of the larynx and trachea in children), I treated it with cold air, which would normally be counter-intuitive for a parent. I find that at work, I have more empathy and sympathy with parents than before I had kids.

It may also be because I have girls that I understand how parents may be protective of their kids. This allows me to relate better with parents and I find that they are comfortable and open with me. Regardless of the gender of the kids, though, I treat every child who walks in at The Pharmacy as my own, taking care to make recommendations based on the child’s needs and specific situation. I appreciate that parents put their trust in us.

On a practical level, I’ve lived through parenting experiences that give me first-hand insights to medical conditions, of both children and mothers, so I have a better understanding of the questions to ask to be able to make more informed recommendations to patients.

As a pharmacist, are you able to navigate the healthcare system better? Does it also help to not be daunted by medical speak?

I understand the context of the healthcare system and how the pieces fit together (insurance, doctors, hospitals) so I have a good idea of who to contact for what my family and I need. This saves time and stress.

Having a pharmacist’s training helps as far as medical terminology, but it doesn’t cover everything, especially as each medical field and specialty has its own terminology. I have questions just like other parents, and I take care to present them right because I respect our care providers professionally.

Would you like your daughters to be pharmacists one day?

My expectation is that they get a higher level education for sure. It can be in pharmacy, science, or another area.

Working in the medical field, are you better informed and thus less stressed as a parent?

Yes, I don’t overreact as much as if I didn’t have my knowledge and experience. My wife is a chiropractor and I think we provide good role models for our girls. The other day we all had blood drawn and the girls, both under 5, just sat there without reacting while their blood was being drawn. My wife and I are able to explain to the girls what’s about to happen, why, and what it’s for, in a way that they can understand. This makes medical visits fairly easy and stress free in our family – knock on wood!

There are stresses of the job because I’m also a partner of The Pharmacy. The business is still fairly young and we work hard to ensure that we’ll continue on solid footing regardless of the pandemic or other market forces. Our strategy is to provide the best service and experience possible for patients and customers. This of course also means continually working at being a good manager and employer for our employees.

How do you find the work/life balance that works for you?

I make sure not to overwork and that I have family time. I prioritize the time that I spend with my daughters.

My wife and I also believe in the importance of exercise and health at home and we practice what we preach. We’re keen to pass this on to our daughters at a young age because we know that it will help with their mental development and physical growth, reduce stress levels, reduce illnesses, etc.

So far, the girls love eating healthy and being active. My older daughter loves to run up and down Pinnacle Mountain (1.2 mile trail with a 750 ft elevation)!

Well, I hope that this blog entry might be interesting for some readers. I look forward to seeing y’all at The Pharmacy – drop by and let me know what you think!

Nick

Oral Health Tips

websites@hibu.com (Hibu Websites) — Mon, 29 Jun 2020 21:35:44 GMT

June 2020

We instinctively know that dental problems such as cavities and gum disease can cause pain, tooth loss, bad breath, impair our ability to eat or speak propery, not to mention the associated cost, so we'll start below with the lifestyle and hygiene tips, focused on prevention. What follows that includes more detailed information about diseases associated with poor oral hygiene and symptoms that signal a trip to the dentist.

Start oral hygiene as soon as a baby's first tooth appears, cleaning it twice a day. For children 3 and younger, use fluoride toothpaste about the size of a grain of rice. After age 3, increase the amount of toothpaste to pea size. It is still important to care for baby teeth because diseased teeth can affect how children eat, talk, and even learn.
Brush your teeth twice a day for about 2 minutes each time, with fluoride toothpaste. Use a brush that fits your mouth and that has soft bristles of varying height. Remember to clean your tongue. Don't brush too overzealously, as you can scrape away tooth structure or damage gum tissue.
If you have just had something acidic to eat or drink, wait at least 30 minutes before brushing your teeth. This gives your mouth time to produce enough saliva to neutralize the acidity and help your teeth absorb more calcium, which then acts like a coat of armor.
Keep your toothbrush clean and replace it every 3 months, when the bristles fray, or after you have been sick.
Gently and thoroughly floss your teeth daily.
Keep your dentures and dental appliances clean. Follow your dentist's recommendations for cleaning them.
Don't use tobacco (to reduce the risk of periodontitis, a severe form of gum disease) and eat a healthy diet (to help suppress inflammation).
Visit your dentist at least once a year. Dental offices in Arkansas are now open and have COVID-19 infection control protocols in place. Know the symptoms that suggest oral health problems so you see a dentist before they worsen.
If your medication causes dry mouth, ask your pharmacist and doctor if there might be a different medication that doesn't cause this condition. If dry mouth can't be avoided, drink plenty of water and chew sugarless gum, which helps to promote saliva production.

Lack of oral hygiene has been associated with diseases affecting other parts of the body

Our mouths contain about 700 species of bacteria, mostly harmless, although some can cause disease. Of course, our mouth is the entry point to our digestive and respiratory tracts. Normally, the body's natural defenses and good oral health care keep bacteria under control, but where the latter is lacking, bacteria can reach levels that can lead to oral infections such as tooth decay and gum disease.

As well, studies suggest that oral bacteria and the inflammation associated with periodontal disease can be associated with diseases such as endocarditis (infection of the inner lining of the heart chambers or valves), chronic respiratory disease, cardiovascular disease, pregnancy and birth complications, dementia, arthritis, and pneumonia. Diabetes, HIV/AIDS, osteoporosis, alzheimer's, and diseases that may reduce the amount of saliva produced (and often causing dry mouth) may also be associated with periodontal disease.

So it makes sense to work on prevention by maintaining good oral health habits, outlined in the tips above. Knowing the first signs of dental problems is also useful, to be able to take action as soon as possible.

Symptoms to watch out for

If you or a loved one has any of these symptoms, it's time to contact your dentist:

redness and swelling of the gums (gingivitis)
bleeding gums
pain inside / outside the mouth that persists for more than a day or two
pockets of pus
gums that have pulled away from your teeth
widening spaces between your teeth
bridges or partial dentures that don't fit as well as they once did
tenderness inside / outside the mouth
blisters and ulcers that don't heal, sores in your mouth
noticeable changes in the color or texture of the soft tissues
sensitivity to hot and cold temperatures
sensitivity to the pressure of chewing or biting
a change in the way your teeth fit together when you bite
persistent bad breath
fever
swelling in your face or cheek
foul or salty tasting discharge
difficulty breathing or swallowing

While waiting for your appointment with your dentist, you may have to administer self-care. In such situations, use caution with over-the-counter (OTC) antiseptic products containing benzocaine, which has been linked to a rare and serious, sometimes deadly, condition called methemoglobinemia, which decreases the amount of exygen that the blood can carry. Talk with your dentist, doctor, or pharmacist before using an OTC antiseptic containing benzocaine.

Conclusion

Oral hygiene takes a bit of work, but your beautiful smile is worth it!

We wish you a fabulous summer, full beautiful smiles and free of dental problems!

Brittany, Nick, and the team

References and resources:

1. https://communityhealth.mayoclinic.org/featured-stories/give-kids-a-smile

2. https://www.health.harvard.edu/topics/oral-health

3. https://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/dental/art-20047475

4. https://www.health.harvard.edu/heart-health/why-your-gums-are-so-important-to-your-health

5. https://www.abc.net.au/health/talkinghealth/factbuster/stories/2011/03/15/3164618.htm

6. https://www.health.harvard.edu/staying-healthy/brushing-up-on-brushing

7. https://www.mayoclinic.org/diseases-conditions/bad-breath/diagnosis-treatment/drc-20350925

8. https://www.legacycommunityhealth.org/newsblog-importance-of-good-dental-hygiene/

9. https://www.health.harvard.edu/topics/oral-health

10. https://www.mayoclinic.org/first-aid/first-aid-toothache/basics/art-20056628

11. https://www.mayoclinic.org/diseases-conditions/tooth-abscess/symptoms-causes/syc-20350901

12. https://www.perio.org/consumer/gum-disease-symptoms.htm

13. https://www.mouthhealthy.org/en/babies-and-kids/fun-ways-to-encourage-kids-to-brush

14. https://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/dental/art-20045536

15. https://www.cdc.gov/oralhealth/basics/adult-oral-health/tips.html

Back to Basics: Physical Activity

websites@hibu.com (Hibu Websites) — Sun, 31 May 2020 02:33:48 GMT

May 2020

We’ve all heard or read about the benefits of physical activity. We might even be well versed in the science behind the benefits. And yet few of us are willing or able to change our lifestyle to incorporate physical activity on a long term basis. Everyone’s situation is different of course, but we thought it might be helpful to share what has worked for us and what some customers have had success with, in hopes of providing inspiration.

First, let’s take a look at the following statements. Which are true? (Answers at the end of this blog.)

1)    There’s not much I can do at home or at the office.
2)    I exercised a lot when I was younger so I’m still fit.
3)    Being on my feet all day is the same as exercising.
4)    Exercising will make me thin.
5)    There’s no use exercising if I don’t want to change what I eat.
6)    I have a chronic disease so I should not exercise.
7)    I’m going to do sit-ups to lose my belly.

Please note that it is recommended to consult a doctor prior to starting an exercise program, especially if you have heart disease, diabetes, kidney disease, cancer, etc.(1)

Be ready to make a change in behavior
We have personally found, despite all the tricks and tips that we can read or talk about and implement, that we need to be personally ready to make changes, and that we are the only ones who know when we’re ready to take the first or the next step.

Change your mindset
When we no longer thought of exercising as a chore or something that we should or have to do, but rather as something that we’d like to do and that we could have fun doing, we started thinking in the realm of possibilities.

What shall I choose to do today? This week? This month?
What do I like doing? Shall I listen to music, a podcast, an audio book, etc. while being active? What do I want to wear that will help me keep motivated?
How can I do it, how can I integrate physical activity into my life?
I’m stuck again. How can I change what’s holding me back?

Keep the physical activity varied

Both aerobic activity and muscle strengthening activity are needed and doing some of both adds variety.
I’m starting to find my activity boring, repetitive, or no longer challenging. What shall I do to change it up? (2)

Take action / Make physical activity a daily priority
It’s never too late to start and something is better than nothing, regardless of your physical condition. We do need to choose activities suitable for our specific health conditions, abilities, etc., and if we ramp up the intensity, we must do so gradually to give time for our bodies to adjust.(3)

My work / my family commitments take up most of my time and energy. I can start small and integrate physical activity into my weekdays or weekends.
I can ask colleagues to join me or I can support colleagues wanting to be more physically active.
I can get the whole family involved. We can make it fun and do it safely.
I have 5 minutes right now. What can I do on the spot?

Back to the statements and whether they are true or not:

1)    There’s not much I can do at home or at the office.
False. Many exercises and physically active choices can be done at home or at the office. Examples: stretching (increases flexibility), using stairs rather than the elevator, squats, lunges, jumping jacks, dips, push ups, glute raises, crunches and sit-ups, the plank, walking, gardening, washing the car, etc.

2)    I exercised a lot when I was younger so I’m still fit.
False. It only takes about two months of inactivity to lose the gains of physical activity.(4)

3)    Being on my feet all day is the same as exercising.
False. Standing all day would be considered an activity of daily living rather than exercising, which is more a structured way to improve physical fitness. However, standing does burn more calories than sitting.(5)

4)    Exercising will make me thin.
Can be true. An increase in physical activity will cause the body to burn more calories and when combined with limiting the intake of calories will result in weight loss. Resistance or strength training will increase muscle strength and mass and benefit muscle and bone maintenance.

5)    There’s no use exercising if I don’t want to change what I eat.
False. While healthy food choices also contribute to overall health, starting with just exercising is still beneficial. Something is better than nothing.

6)    I have a chronic disease so I should not exercise.
False. A person with a chronic disease should consult with their doctor prior to starting an exercise program and be more careful about the type, frequency, intensity, etc. of their physical activity. Exercise can benefit everyone.

7)    I’m going to do sit-ups to lose my belly.
False. Spot exercising, such as doing sit-ups, can tighten abdominal muscles, but it won't get at visceral fat.(6, 7) If you’re interested in what makes belly fat different from other fat, subscribe to our email list to view the May 2020 newsletter here: http://eepurl.com/b4pW5X

Last but not least, we’re more than happy to work with you to identify, reach, and maintain your health goals and improve your quality of life. We’re all about empowering you to have fun!

Brittany, Nick, and the team

References and resources:

1. https://www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/exercise/art-20047414

2. https://www.cdc.gov/physicalactivity/basics/adults/index.htm

3.    https://www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/exercise-intensity/art-20046887
4.    https://www.verywellfit.com/can-i-take-a-break-from-exercise-without-losing-fitness-1231204
5.    https://newsnetwork.mayoclinic.org/discussion/standing-several-hours-a-day-could-help-you-lose-weight-mayo-clinic-research-finds/

6. https://www.health.harvard.edu/staying-healthy/abdominal-fat-and-what-to-do-about-it

7. https://www.abc.net.au/news/health/2016-02-23/weight-loss-can-you-target-certain-areas/7193094

8. Fitness assessments: https://www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/fitness/art-20046433?mc_id=us&utm_source=newsnetwork&utm_medium=l&utm_content=content&utm_campaign=mayoclinic&geo=national&placementsite=enterprise&cauid=100721

Allergy Season Amid Coronavirus

websites@hibu.com (Hibu Websites) — Wed, 15 Apr 2020 12:25:21 GMT

April 2020

Without the worry of getting infected by SARS-CoV-2, allergy season can already cause miserable symptoms for people with hayfever or allergic rhinitis, the form of allergies that may cause:

Sneezing, itching of the nose, eyes, or roof of the mouth
Runny, stuffy nose
Cough due to post-nasal drip (mucus from the sinus passages that trickle down the back of the throat)
Watery, red, or swollen eyes (conjunctivitis)

Kids and people who have a family history of allergies are more likely to develop an allergy, but it can happen to anyone, start at any time, and range from mild to severe. Allergic rhinitis is generally caused by pollen, animal dander, dust mites, and/or mold.

What is allergic rhinitis?

An allergic response occurs when the immune system produces proteins (antibodies) that mistakenly identify a harmless substance, such as pine tree pollen (pictured above), as an invader. In an attempt to protect your body from the invader, or allergen, antibodies bind to it. The antibodies also signal your immune system to release chemicals which lead to allergy symptoms such as those in the bullet points above. For some people, this same reaction also affects the lungs and airways, leading to asthma symptoms.

Precautions to take for allergic rhinitis

If you suspect having an allergy and have not been diagnosed, start a diary of activities, foods, symptoms, what seems to help and what doesn't, to assist you and your healthcare professional to identify triggers. If the triggers are known, do your best to avoid them even if you are treating your symptoms. For example, if you are allergic to pollen, check local pollen levels online before spending time outdoors. As an aside, you'll notice that the pollen level will be lower right after a heavy rain.

Several types of over-the-counter and prescription medications can ease allergic rhinitis symptoms: antihistamines, decongestants, allergy shots, etc. Speak with your healthcare provider to determine the best one or combination for you.

What do we currently know about the symptoms of COVID-19?

Our knowledge of this illness is continually evolving and currently the CDC (Centers for Disease Control) and WHO (World Health Organization) note that these symptoms may occur between 2 and 14 days of being exposed:

Fever
Cough
Shortness of breath

Other, less common symptoms may include:

Aches and pains
Nasal congestion, runny nose
Sore throat
Diarrhea

Please note that this is not an exhaustive list and that you should contact your medical provider if you have other symptoms that are severe or concerning.

If you suspect you have coronavirus, call your doctor for medical advice. If you have Medicare, you might be able to have a virtual visit with your doctor. The government has temporarily expanded the coverage of telehealth services during the coronavirus pandemic.

Putting it all together

What is the best thing for someone with allergies to do in today's circumstances?

Manage your allergies and treat the symptoms
Be vigilant, take precautions to stop the spread:

stay at home
wash your hands for 20 seconds frequently, and especially:

before eating
after coughing, sneezing, blowing your nose
before touching your eyes, nose, or mouth

practice physical distancing

The following chart, by the Asthma and Allergy Foundation of America and updated on March 27, 2020, can serve as a guide, but do call your medical professional if you have symptoms and questions.

If you have any questions, please do not hesitate to call us (501-708-4320). We are open regular hours and have modified our operations to serve you via our drive-thru, including parking lot service, and our regular delivery service. We're here for you!

Brittany Sanders, Pharm.D.

References and further information:

https://www.mayoclinic.org/diseases-conditions/allergies/symptoms-causes/syc-20351497
https://www.mayoclinic.org/diseases-conditions/asthma/in-depth/allergies-and-asthma/art-20047458
https://asthmaandallergies.org/asthma-allergies/allergy-basics/
http://pollen.aaaai.org/nab/index.cfm?p=allergenreport&stationid=161&datecount=04%2F10%2F2020
https://acaai.org/resources/tools/symptoms-test
https://www.health.harvard.edu/staying-healthy/3-ways-to-manage-allergies
https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html
https://www.who.int/news-room/q-a-detail/q-a-coronaviruses
https://community.aafa.org/blog/coronavirus-2019-ncov-flu-what-people-with-asthma-need-to-know
https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/testing.html
https://www.medicare.gov/medicare-coronavirus#500
https://www.aafa.org/asthma/asthma-triggers/other-health-conditions/respiratory-infections/covid-19-new-coronavirus.aspx

Back to Basics: Sleep

websites@hibu.com (Hibu Websites) — Tue, 17 Mar 2020 18:52:57 GMT

Read about sleep in this first blog of our new Back to Basics series.

March 2020

With so much in the news lately about staying healthy, we thought it might be a good time to start a "Back to Basics" series. We'll review different aspects of staying healthy, including the latest scientific thinking, as well as practical ideas for everyday life. We hope that you enjoy and learn from this series. Please feel free to let us know what you think! First topic: sleep.

What do we understand about sleep?

"That we are not much sicker and much madder than we are is due exclusively to that most blessed and blessing of all natural graces, sleep."

- Aldous Huxley

It turns out that we really don't fully understand sleep. We know the short term effects of not getting enough quality sleep:

An occasional night without sleep makes us feel tired and irritable the next day. We're also not as alert, we may feel unfocused, and get dark circles under our eyes.
After several sleepless nights, the mental effects become more serious. It becomes more difficult to concentrate, think clearly, remember things, and/or process information. We're moody and are more likely to have conflict with others. We may doze off during the day and the risk of accidents and injuries goes up.
If it continues, lack of sleep becomes an important risk factor for serious medical conditions such as diabetes, cardio-vascular disease and hypertension, and obesity. Sustained lack of sleep reduces our immunity to illness, affects our hormones, increases our anxiety levels, and affects our overall health.

We also know the effects of getting sufficient sleep:

Kids who get a good night's sleep are more likely to show a positive outlook towards school and are more likely to have healthy behaviors such as working to finish tasks started, staying calm and in control when faced with a challenge, etc.
Deep sleep can decrease anxiety by reorganizing connections in the brain. It seems to be a natural anxiety inhibitor, so long as we get it every night.
Sleeping well wards off the negative effects of not getting sufficient sleep, as described above.
When we're well rested, we're able to respond to life with greater perspective and understanding.

" Sleep is the best meditation. "
- Dalai Lama

Scientists have several theories of why we sleep (link to Harvard Medical School article ), and they continue to study this topic. If you're interested in learning more, the Public Broadcasting Service (PBS) premiered " The Mysteries of Sleep " in February 2020.

So what can we do to get a good night's sleep?

We recognize that many factors can affect the quantity and quality of our sleep: work stress, family responsibilities, travel, unforeseen challenges, etc. While we may not be able to control those factors, we can adopt habits that encourage better sleep. Here are some ideas:

Stick to a sleep schedule -- go to bed and get up at the same time every day. Try to limit variances in your sleep schedule to no more than an hour. Being consistent reinforces your body's internal clock. If you don't fall asleep within 20 minutes, get up and do something relaxing. Try going to bed again when you feel tired. Repeat as needed.
Have a bedtime routine -- adopt a relaxation activity or technique before going to bed. For example, reading, taking a bath, listening to music, deep breathing, meditation, gentle stretching, etc.
Pay attention to what you eat and drink -- don't go to bed hungry or stuffed. Try to avoid heavy or large meals within two hours of bedtime. The stimulating effects of nicotine and caffeine are likely to prevent quality sleep, and while alcohol may make you feel sleepy, it can disrupt your sleep later on in the night.
Create a restful environment -- cool, dark, and quiet. Avoid prolonged use of light-emitting screens just before bedtime.
Limit daytime naps -- as they can interfere with nighttime sleep. If you choose to nap, limit them to 30 minutes and avoid napping late in the day.
Include physical activity in your daily routine -- but not too close to bedtime because exercise stimulates the body to secrete the stress hormone cortisol, which helps activate the alerting mechanism in the brain.
Use light to your advantage -- natural light keeps your internal clock on a healthy sleep-wake cycle. Let in the light first thing in the morning and go outside during the day for a sun break.
Manage worries -- try to resolve concerns before bedtime. Jot down worries and put them aside for the next day.

Conclusion

Some of these tips will be easier to include in your daily and nightly routine than others. However, if you stick with them, your chances of achieving restful sleep will improve. We all experience sleepless nights and lack of sleep from time to time, but if this happens too often or regularly, it may be time to consult with your doctor to determine and treat underlying causes.

Please also feel free to speak to us at the pharmacy -- we're happy to help and we want all of our patients and customers to experience the feeling of well-being that consistent, good quality sleep can give.

We wish you a good night!

Brittany Sanders, Pharm.D.

References and further information:

Special thanks to our friend Dr. Don Martin, who provided inspiration for this post.

Please feel free to let us know if you'd like us to write about a particular topic. You may also like to sign up for our monthly email newsletters (below) where we also write about relevant health-related topics.

Advance Care Planning

websites@hibu.com (Hibu Websites) — Mon, 17 Feb 2020 21:45:29 GMT

For both parents and adult children

February 2020

Whether you’re a parent with adult children or an adult whose parents continue to be part of your life, it may be time to proactively plan for advance care or unforeseen health/disability issues.

In 2017-2018, 16% of Americans provided caregiving to an adult aged 65+ years. (*1) Due to the large baby-boomer generation, this number is likely to increase.

There isn’t a one-size-fits-all approach, but in general, honestly discussing expectations and plans will help everyone to be more ready to manage sudden or unforeseen events or to plan for the longer term.

Here are a few tips for broaching this sensitive topic :

Look for everyday occasions to bring up the conversation informally. Cues may include:

A parent commenting about aging, health issues, or financial plans,
An adult child asking for health or financial advice,
The illness or passing of a close friend

Don’t press the subject if it feels uncomfortable; instead, try again at the next opportunity.

Topics to cover during the discussion or over the course of several discussions may include :

The current status

Existing health issues and insurance(s)
Any plans for care that have already been arranged

Future plans envisioned for:

Personal care
Financial affairs
Covering costs for living arrangements, health care, social activities, transportation, etc.

Options and ideas to consider:

Having the adult child accompany the parent to the next (few) doctor’s appointment(s) and/or to the pharmacy
Exploring employer benefits for caregiving leave or sharing responsibilities with other family members
Family dynamics, cultural obligations, language barriers, levels of independence/control for the situation
Caregiver tax credit, respite services for caregivers, long-term care insurance
Joint accounts or joint ownerships, including considering tax consequences, creditor or legal claims on joint assets, etc.
The location of key information such as:

Living Will, Medical Power of Attorney, Durable Power of Attorney for Asset Management, Will, insurance policies, list of financial assets, list of names and contact details for key individuals (doctors, specialists, dentist, optometrist, pharmacist, insurer, religious leader, financial advisor, etc.), key passwords, etc.

The aging process can be stressful enough on its own. Setting the stage for honest and open communications can help to alleviate emotional, physical, and financial concerns related to advance care before they become issues.

Last but not least, our pharmacists have experience liaising with caregivers and aging parents. Please feel free to discuss medication, health, and caregiving topics with us.

*References and useful resources:

Statistics re eldercare per the Bureau of Labor Statistics: https://www.bls.gov/news.release/elcare.nr0.htm
U.S. Department of State - webpage about eldercare, including resources: https://2009-2017.state.gov/m/dghr/flo/c23133.htm
U.S. Department of Health and Human Services - webpage about aging, including resources: https://www.hhs.gov/aging/index.html
National Institute on Aging - webpage about important papers: https://www.nia.nih.gov/health/getting-your-affairs-order#important-papers
Family Caregiver Alliance list of important papers: https://www.caregiver.org/where-find-my-important-papers
PBS Newshour article about how to care for aging parents from a distance: https://www.pbs.org/newshour/health/long-distance-caregiving-parents
The Atlantic article about what aging parents want from their kids: https://www.theatlantic.com/health/archive/2016/03/when-youre-the-aging-parent/472290/
Various questions to ask yourself before becoming your parent's caregiver:

https://info.daystarseattle.com/senior-living-blog/before-becoming-your-parents-caregiver-ask-yourself-these-questions
https://www.waterfallhomecare.com/senior-home-care-blog/questions-to-ask-before-becoming-a-caregiver-to-parents
https://www.nia.nih.gov/health/frequently-asked-questions-about-caregiving

The Secret to Preventing Cervical Cancer

websites@hibu.com (Hibu Websites) — Thu, 23 Jan 2020 00:19:47 GMT

January 2020

January is Cervical Health Awareness Month and we would like you to know that there is no secret to preventing cervical cancer. It involves simple steps: vaccinating early and getting screened regularly.

Vaccinate early: it is recommended that males and females be vaccinated against Human Papillomavirus (HPV) at age 11-12. The vaccine produces a stronger immune response when taken during the preteen years, but everyone can be vaccinated through age 45.

Screen regularly: Females should start with a Pap test at age 21 and an HPV test starting at age 30. Talk with your doctor about how often you should be screened for each test.

What is HPV and what else should I know?

Most cervical cancers are associated with HPV, which is spread through intimate skin-to-skin or sexual contact. HPV is very common and most sexually active individuals in the U.S. will become infected with HPV in their lifetime. In most cases, the virus is cleared by the body's immune system within two years, but when that doesn't occur, HPV infections can lead to cancers of the cervix, vagina, vulva, anus, penis, and throat.

Gardasil 9 is an HPV vaccine approved by the U.S. Food and Drug Administration (FDA) for both males and females.

In females aged 9 to 45, it helps to protect against:

Cervical cancer
Vulvar and vaginal cancers
Anal cancer
Precancerous cervical, vulvar, vaginal, and anal lesions
Genital warts

In males aged 9 to 45, it helps to protect against:

Anal cancer
Precancerous anal lesions
Genital warts

The HPV vaccine is recommended for administration starting at age 11 or 12, although it can be given as early as age 9 and as late as 45. It is ideal for males and females to receive the vaccine before they have sexual contact and are exposed to HPV. Research has shown that receiving the vaccine at a young age isn't linked to an earler start of sexual activity.

If a person already has one strain of HPV, s/he can still benefit from the vaccine because it can protect against other strains that the person doesn't yet have.

Based on ongoing assessments of the safety of this vaccine, the U.S. Centers for Disease Control and Prevention (CDC) and the FDA continue to find that this vaccine is a safe and effective vaccine.

The HPV vaccine does not prevent all HPV types that can cause cancer, so a female who is vaccinated should still get regular Pap tests. Pap tests remain an essential part of preventive health care as they can help to detect abnormal (changed) cells early, before they turn into cancer. Most deaths from cervical cancer could be prevented by regular screenings and follow-up care.

Drop by to ask us any questions about this vaccine or your insurance coverage. Find out if Gardasil 9 is right for you or a loved one, as there are contraindications.

Brittany Sanders, Pharm.D.

References and more information:

https://www.mayoclinic.org/diseases-conditions/hpv-infection/in-depth/hpv-vaccine/art-20047292
https://www.cancer.gov/about-cancer/causes-prevention/risk/infectious-agents/hpv-vaccine-fact-sheet#how-safe-arenbsphpv-vaccines
https://healthfinder.gov/nho/januarytoolkit.aspx
https://www.nccc-online.org/wp-content/uploads/2019/01/CHAM_2019_Secret.pdf
https://www.washingtonpost.com/health/2018/10/05/fda-approves-hpv-vaccine-people-up/
https://www.nccc-online.org/images/pdfs/10ThingsHPV_CCAM.pdf
https://www.fda.gov/media/90070/download
https://www.cdc.gov/vaccines/hcp/vis/vis-statements/hpv.html

Medicare enrollment, Narcan

websites@hibu.com (Hibu Websites) — Mon, 14 Oct 2019 06:46:10 GMT

This month’s post is about a product that is available to the public that is saving lives daily. Also, read about how we can help you with enrolling and re-enrolling in Medicare Part D.

Most of us know about, or worse, have been affected by, the opioid epidemic. While prescription drugs do wonderful things to help people and their quality of life, there is a more difficult side that is a matter we have no intention of skirting.

Hopefully, you never happen upon someone who is in the middle of a drug overdose; but read on and if you do, you will potentially be able to save a life.

Naloxone, or Narcan, is a life-saving medication that can reverse the effects of an opioid overdose. It can be injected intramuscularly or delivered by intranasal spray, and what’s more valuable is that it can be administered by medical professionals and family, friends, or bystanders in an emergency where someone is experiencing an overdose.

Some signs of overdoes are:
Unable to be awakened
Unable to speak
Breathing or heartbeat slows or stops
Pale face
Limp body

In Arkansas, there is a standing prescription from the Secretary of Health, Dr. Nate Smith, that allows Arkansans to request Narcan without a direct prescription from a doctor. A CDC* study found that there is only one naxolone prescription for every 69 high-dose opioid prescriptions in the United States. Naloxone has no potential for abuse, making it safe to have with you at all times.

For more information, talk to your pharmacist about getting a Narcan dose for yourself and your family. Your pharmacist can walk you through how to administer the dose, and you can keep it in your purse, workplace, or at home. We at The Pharmacy at Wellington dispense the nasal spray dose that is very easy to use. We never know when this valuable prescription could save the life of someone we know. In this case, we stand by the old adage – the best offense is a good defense.

For more information about Narcan and how the state is involved, download the Narcansas app from the Apple App Store or Google Play , or visit www.narcansas.com .

* Center for Disease Control

Most Americans enroll in Medicare at age 65 and re-enroll every October thereafter. This year, enrollment for most patients starts on Tuesday, October 15 and runs through to December 7.

During this period, you can join or switch plans, including for Medicare Part D, which covers prescription drugs. Whether you decide to go with Original Medicare or Medicare Advantage, you can determine which Part D drug plan is most suited for you by using the Medicare Plan Finder tool at: www.Medicare.gov

Alternatively, drop by and we can run comparables for you or your loved one, based on the current medications, so that a more informed choice can be made.

**NEW** If you have been on Medicare, you should have received your new Medicare card without your Social Security number. Its purpose is to offer better identity protection. Call or drop by to let us know your new Medicare Beneficiary Identifier so that we can update it in our system.

7 Can't Miss October Events

websites@hibu.com (Hibu Websites) — Fri, 27 Sep 2019 22:05:00 GMT

We'd like to share some of our favorites:

1) HarvestFest in Hillcrest

Saturday, October 12, 11 a.m. 9 p.m.

Little Rock's premier local favorite fall festival is back! With more than 100 vendors and plenty of food trucks, live music, local beer, crafts, kids' activities and more, Hillcrest HarvestFest is perfect fall fun for the entire family!

This year's sponsor is Hill Station, the new restaurant coming to Hillcrest this fall. Make sure to stop by while you're at HarvestFest and get your first look at Hill Station and what it will bring to the neighborhood. HarvestFest is a subcommittee of the Hillcrest Merchants Association, which works to promote businesses and community projects in the Hillcrest neighborhood.

Information:

https://www.facebook.com/hillcrestharvestfest/

https://harvestfest.us/

2) World Cheese Dip Championship at the Clinton Presidential Center

Saturday, October 5, 12:00 p.m. to 4:00 p.m.

DIP, SIP, REPEAT at the 9th Annual World Cheese Dip Championship ! Make your taste buds heard and vote to help crown the World Cheese Dip Champions. Our very own pharmacist Susan is entering her delicious dip again! It came in 2nd overall last year -- come try it and YOU be the judge!

All proceeds benefit Harmony Health Clinic. HHC provides free medical and dental services to the uninsured in Pulaski County. For more information, visit www.harmonyclinicar.org

Information and tickets:

https://cheesedip.net

Facebook page

3) Boo at the Zoo at the Little Rock Zoo

Friday, October 25, 6 p.m. - Friday, November 1, 9 p.m.

It's Arkansas's favorite time of year! It's time to enjoy Boo At The Zoo! It's their 28th year, and this year they have better candy, better events, and better Boo For You! Join in Little Rock's most loved Halloween tradition -- costume contests, live music, a haunted train, candy stations, family activities, and a beer garden for adults. It will be spooky fun for everyone. So go, enjoy the traditional Boo activities while we welcome new ones...go love the Zoo, and go love Boo at the Zoo!

Information and tickets:

https://littlerockzoo.com/default.aspx?p=80708&evtid=1460839:10/25/2019

4) Chili Fights in the Heights on Kavanaugh between N. Taylor and N. Polk

Saturday, October 26, 11 a.m. - 6 p.m.

It's that time of year again! Chili Fights in the Heights is a family friendly event put on in conjunction with the Heights Neighborhood Association and Heights Business Association (along with the help of a few fun oriented citizens) with the hope of bringing the community together, showing off our unique area of town and generating a charitable donation for the Arkansas Foodbank.

Admission is FREE, but tasting kits will be available for purchase at the event!

Information:

https://www.hatclublr.com/events.html

https://www.facebook.com/ChiliFightsInTheHeights/

5) Festival of Darkness , Nighty Night Release Party & Celebration of Dark Beer at Lost Forty Brewing

Saturday, October 26, 5 p.m. - 9 p.m.

Darkness is coming. And with it, one hellacious party. Sponsored by Lost Forty Brewing, their biggest, baddest, boldest 3 Barrel-Aged 2019 batch of Nighty Night Imperial Stout makes its limited debut Oct. 26th. Gather your ripped plaid shirts, your chainsaws, your axes, your boots, your best post-zombie-apocalypse look and join us for the Lost Forty Brewing Festival of Darkness: Nighty Night 2019 Release Party.

Information:

https://www.facebook.com/events/777033439314735/

6) Oktoberfest Celebration at Fassler Hall

Saturday, October 5, 11:00 a.m. to Sunday, October 6, 2:00 p.m.

Dust off your lederhosen and dirndl and raise a stein at the annual Oktoberfest Celebration!

They have a weekend full of fun & games, live music, delicious German food, and of course plenty of German beer to wash it all down! Save the date! Prost!

Information:

https://www.facebook.com/events/387944605198864/

7) Arkansas Cornbread Festival on South Main Street

Saturday, October 26, 11 a.m. - 4 p.m.

The Arkansas Cornbread Festival promotes the businesses and neighborhood in the South Main (SoMa) Community. Celebrating community and southern culture through music, activities, local brews and of course food. Bring the family to try some delicious cornbread!

Information:

https://www.facebook.com/events/322423378606868/

And a BONUS -- right in our own parking lot! Drop by and do good for the community:

8) Drug Take Back and Diaper Drive

Saturday, October 26, 12 p.m. - 2 p.m.

15400 Chenal Parkway (at Wellington Hills behind the bank)

Drive through our parking lot and drop off your expired prescription drugs and bring a box of diapers!

Disposing of drugs safely helps to keep them from unintentionally getting into the wrong hands. 90% of prescription drug addictions start in teenage years. Police officers will be onsite to collect the drugs taken back.

Providing diapers is a concrete way to help struggling parents. Without diapers, babies cannot participate in most day care and early childhood education programs. Without child care, parents cannot go to work. A Yale University School of Medicine study has found that women who lack an adequate supply of diapers for their babies are more likely to report symptoms of depression and anxiety than other low-income mothers. Maternal depression and mental health problems, the researchers say, can have long-term and debilitating effects on children’s well-being and their performance in school.

Call us or drop by if you have any questions.

We look forward to seeing you drop by our parking lot on October 26th!

ALSO: coming on weekend days in early December, at The Pharmacy at Wellington:

Holiday Gift Wrapping by Donation -- Proceeds will benefit Project Zero

Dates will be posted on our Facebook events page
Come get your holiday gifts wrapped and donate to Project Zero, which diligently and enthusiastically promotes adoption through the foster care system, with the ultimate goal of finding a forever family for every child who is waiting.

Get to Know Us

websites@hibu.com (Hibu Websites) — Wed, 28 Aug 2019 20:40:22 GMT

Welcome to our very first blog! We decided to start this as a way to keep you, our patients and customers, informed about relevant topics. We look forward to sharing information and our thoughts and welcome your comments, feedback, and suggestions. Feel free to drop by or give us a ring to let us know what you think! First topic... what do we do at The Pharmacy?

Before we studied pharmacy, some of us thought that pharmacists just counted pills and put them in containers! �� But after our many years of experience, we feel blessed to be able to make a positive impact on people's lives. So what do we do behind the counter, and why are we always on the phone? Well, to give you an idea, here's a typical weekday:

We say we're here for you... we really are! ��

We thank the artists on Pixabay for making available the above vector images.

Blog Page of The Pharmacy at Wellington

Arkansas Drug Take Back

Women's Health

Is it better to write by hand or type?

Winter Wonderland

Dads and healthy babies

Maximizing your workouts

Get your best skin this fall!

Eye Care

Rinsing off before getting in a pool

Sun Protective Clothing

Mosquito bites

It's time to talk about ticks

Soft as Baby Skin

Our own Liz E. is a certified CHW!

Syphilis is making a comeback, including in Arkansas

How's your liver doing?

Winter skin care

Different ways of taking medications

A Few Minutes with Mary

Bad Breath

Did you know?

Chickenpox and Shingles

Melatonin and sleep

Weight training and women

International Women's Day

Our Eyes and the Eclipse

Spotlight on Susan

Back to Basics: Breathing

Have you heard?

OTC medications

Left-Handedness

Get to know Constanza -- Conocer a Constanza

Recognizing Heat Illnesses

Did my child have a concussion?

Iron in our bodies

Neuroscientific tips for learning

Am I losing too much hair?

Back to Basics: Stretching

FUN FACT:

The human body has approximately 600 muscles!

FUN FACT:

FUN FACT:

FUN FACT:

To help increase underwater dive time, approximately 50% of a beluga whale's total body oxygen store is found in its skeletal muscle. In contrast, humans only store 15% of our oxygen reserves in our skeletal muscle (muscles that we control, for example, our leg muscles).

BONUS FUN FACT:

We couldn't resist including one more fun fact, this time about chimpanzees.

Why are chimpanzees stronger than humans?

Because they have more fast-twitch muscles than humans do!

It's freezing!

What is the ONE thing you can do to improve your health?

Workout Fuel

What do people ask us pharmacists?

New vaccine against COVID-19

Healthy Bones

Snot? That's Gross!

Fiber -- what's the big deal?

Drug Take Back Day

National Kidney Month

Healthy Skin Habits

QR Code for COVID-19 Test Results

We provide a QR code with your COVID-19 TEST result. It can be used* for:

Additional information:

Sweet, sweeter, sweetest

Pharmacist in ... Japan

The Power of Plants

No Sweat! ... despite the heat...

The Pharmacy at Wellington's Temporary COVID-19 Vaccine Clinic

Not All Vaccines Are Created Equal

Back to Basics: Nutrition

Thank You The Pharmacy at Wellington Team!

Put Your Best Feet Forward

COVID-19 Tests at The Pharmacy at Wellington

We're Here to Help

Back to Basics: Water

Nick on Being a Pharmacist Dad

Oral Health Tips

Back to Basics: Physical Activity

Allergy Season Amid Coronavirus

Back to Basics: Sleep

Read about sleep in this first blog of our new Back to Basics series.

March 2020

For both parents and adult children

February 2020