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I have a nasty cold and sore throat, but my doctor does not give me an antibiotic. Won’t an antibiotic “kill” the bug more quickly?

Sofie says: Physicians at SoFHA don’t prescribe antibiotics “at the drop of a hat,” because the medications will only successfully treat illnesses caused by bacteria, such as strep throat. Antibiotic meds won’t work against viral bugs, which cause the common cold, flu, most sore throats, bronchitis and many sinus and ear infections. In these cases, the best medical advice is: “Go home, rest, and drink plenty of liquids.”

If my cold was caused by a virus, how can taking an antibiotic do me harm?

Sofie says: Antibiotics not only kill bad bugs in your body but also good bacteria that is needed to stay healthy. If that internal balance of bacteria gets thrown off, you could experience other negative symptoms – such as diarrhea, throat or vaginal infections, nausea and vomiting, or breathing problems. Repeated use of antibiotics if you don’t need them can also give rise to “super bugs” like MRSA or resistant staph that have out-smarted certain antibiotics and are difficult to kill. It’s best to take an antibiotic only if it can truly address your illness. Hold off, otherwise.

What if I strongly feel my illness was caused by bacteria?

Sofie says: Ask your physician to do a lab test to determine exactly what bacteria you have and which drug you need. If you do receive an antibiotic, take your medication exactly as directed. Stopping early just because you’re feeling better isn’t a good idea and contributes to drug resistance.

My SoFHA doctor refuses to give me a CT scan or MRI test – even though I have shooting pain in my lower back and left leg? Why is he being so stubborn?  

Sofie says: You only need an imaging test if you’re also having other extreme symptoms – such as high fever, problems with reflexes, loss of bowel or bladder control or extreme leg weakness. You don’t need one – at least not immediately – if general lower-back pain is your only symptom. By refusing to order a CT scan or X-ray, your doctor is protecting you from radiation exposure that can add up over time and potentially lead to cancer. Follow your doctor’s advice. Most people with lower-back pain feel better in about four weeks anyway – regardless of whether or not an imaging test was given.

I’m 15 years old, and my mom is refusing to let me go to a tanning salon in my neighborhood. Isn’t using a tanning bed safer than actually being in the sun?

Sofie says: Actually, no. It doesn’t matter whether you get exposure from the sun or from artificial sources such as sun lamps and tanning beds — ultraviolet (UV) radiation is linked to skin cancers (including basal cell carcinoma, squamous cell carcinoma, and melanoma) and to other sorts of skin damage, particularly premature skin aging (photoaging).

Over the last 20 years, tanning bed use, particularly among teen girls and young adult women, has become epidemic. In fact, reducing the harms of indoor tanning was one of five goals outlined in the 2014 U.S. Surgeon General’s “Call to Action to Prevent Skin Cancer.” In addition, in late 2015, the FDA issued a proposed rule with the following restrictions for sunlamp products (indoor tanning beds and booths): (1) to ban their use among individuals younger than 18 years; (2) to require prospective users to sign a risk acknowledgment certification; and (3) to provide user manuals to customers and tanning facility operators on request.

If I’m always indoors (to avoid UV rays) and wear sunscreen outdoors, how can my body absorb enough vitamin D?

Sofie says: Eating the right foods is one way to compensate for lack of sun exposure. First of all, nearly all milk in the United States is fortified with vitamin D – as are many brands of orange juice, yogurt, margarine, and ready-to-eat breakfast cereals. You can also regularly add one of the three top vitamin-D super foods to your diet: salmon (especially wild-caught), mackerel (especially wild-caught; eat up to 12 ounces a week of a variety of fish and shellfish that are low in mercury), and mushrooms exposed to ultraviolet light. Others foods rich in vitamin D are tuna (canned in water), sardines (canned in oil), beef or calf liver, egg yolks, and cheese.

Since I retired last year, I’ve felt “down” and not up for doing much. What’s the problem?

Sofie says:  You’ve had a big change in your life (retirement); it’s possible you’re depressed due to being more isolated and less challenged. To get a clear diagnosis, see your physician to rule out any other medical issues that might be affecting your mood, such as anemia or thyroid disorder. Talking with your SoFHA physician will direct your attention toward developing a plan for recovery.

I have an aunt, age 75, who was once fun-loving and enjoyed attending family get-togethers. Now, she’s refusing to go anywhere and has stopped cleaning her house. What has happened?

Sofie says:  The fact is that older women, in general, are twice as likely as men to become seriously depressed. Many factors play into this, such as biological factors (hormonal changes) and social expectations. Often the tasks of caring for ill loved ones and children typically fall more heavily on women, which can lead to depression. Encourage your aunt to get a physical exam and to talk with her doctor about ways to beat the sadness.

What are the most important takeaways in the 2015-2020 Dietary Guidelines for Americans?

Sofie says: The report stresses that a lifetime of healthy eating helps prevent chronic diseases, such as obesity, heart disease, high blood pressure and diabetes. The main takeaways from the latest edition are:

  • Develop and follow a healthy eating pattern across your lifespan.
  • Limit calories from added sugars and saturated fats.
  • Reduce sodium intake.
  • Shift to healthier food and beverage choices.

Below are some specific ideas for making healthier food and beverage choices:

  • Drink plain water, coffee or tea (minus any added sweeteners) with meals, and limit your consumption of diet drinks, fruit juices and milk.
  • Avoid drinking sweetened sodas, sports beverages and energy drinks.
  • Eat dried beans at mealtime several times a week; they’re a great source of protein and contain fiber, vitamins and minerals. Examples include black, lima, and pinto beans; lentils; dried peas such as black-eye and split; fat-free refried beans; and vegetarian baked beans.
  • Choose breads that are labeled 100% whole grain. Whole, intact grains contain fiber and nutrients that get stripped away when they are refined into flour.
  • When cooking, always use whole-wheat flour, instead of all-purpose white flour.
  • Choose fresh grapes over packaged raisins. They contain far less calories and sugar.
  • Instead of eating fried rice or pasta and rice mixes that contain high-fat sauces, choose rice or pasta (without egg yolk) with vegetable sauces.

I have a very stressful job and often feel overwhelmed. Could this eventually hurt my overall health?

Sofie says:  Yes, constantly feeling “under pressure” can take a toll and might bring on a multitude of other symptoms – such as irritability, depression, stomach problems, sexual dysfunction and increased use of alcohol or drugs. At some point, your immune system could weaken – causing even more serious health issues. Consider changing your situation or find ways to counteract the stress. You’ll be happier and healthier for it!

My SoFHA doctor wants me to get the new shingles vaccination, but I’m not sure, what are the benefits of this vaccine and how does it compare to the previous shingles vaccine?

Sofie says: Shingles is caused by the same virus that causes chicken pox and once you’re infected, the virus stays in your body forever. Every year, about 1 million people get shingles which is a painful blistering rash and can cause a complication called post-herpetic neuralgia where the pain can last long after the rash clears.

One way to decrease your chances of getting shingles and resulting complications is to be vaccinated. The traditional vaccine (Zostavax) uses a live but weakened version of the whole virus and offers about a 50% decrease in getting shingles. The new vaccine (Shingrix), approved October 2017, uses pieces of the virus to give protection and is given in two separate shots, which offers a 97% decrease in shingles for those aged 50-69 and a 91% decrease in shingles for those over 70. Because of this, experts are recommending Shingrix for adults over 50 even if they have already been vaccinated with Zostavax. It’s also important to know that you can get the vaccine even if you’ve already had shingles to protect yourself from getting it again.

Why is there a Beers Criteria – a list of drugs that should be taken with caution by older adults, especially people with certain diseases or disorders?

Sofie says:  The drugs on that list can make specific conditions worse. Let’s say you’ve been diagnosed with heart failure, and you also need a pain reliever. A popular group of pain killers called non-steroidal anti-inflammatory drugs or NSAIDs” (e.g., ibuprofen and naproxen) would probably relieve your pain, but they might also worsen your heart failure. In light of that, your healthcare professional should recommend another kind of pain reliever that won’t make your heart failure worse – such as acetaminophen (Tylenol is one brand) – or a non-drug.

I’m in my 70s and started taking a new medication about a month ago. The drug is listed on the 2015 Beers Criteria list of meds that are considered “inappropriate for older people.” Since I started taking this drug, I’ve been having headaches more often. I’m worried that the headaches are a side effect from taking this new medication. Should I stop taking it?

Sofie says: Never stop taking a drug without first consulting your SoFHA physician. Abruptly stopping a medication can be dangerous. Remember:  Your healthcare provider has prescribed the medication to treat or prevent a health problem you have or are at risk of developing. If you’re concerned the new drug – or any drug – is causing side effects, you should let your SoFHA physician know right away. You should also tell him or her whenever you think a medication isn’t working for you.

Keep in mind that every symptom you have while taking a medication or medications may not necessarily be a side effect. You may be having headaches for reasons unrelated to your medication – for example, from lack of restful sleep at night. Still, don’t hesitate to contact your SoFHA physician if you think you’re experiencing a “bad reaction” to any medication. Allow him or her to investigate and figure out what is happening.

Now that I’ve turned 50, I know I should get a colonoscopy, but I don’t have the time or money right now to do the test. Also, I’ve heard it’s very unpleasant. Is getting the test really necessary if I’m not having symptoms?

Sofie Says: A major problem is that many people who have early-stage colorectal cancer don’t experience symptoms, which means you can get the disease and not even know it! It’s the second leading cancer killer in the country, with about one out of every 20 Americans getting the illness.

Because the cancer is found most often in older adults, a first screening is recommended at around your age (50 years old). The thing to remember is that colon cancer is easy to treat if found early enough and can even be prevented altogether if regular screenings are done. If cost is an issue, remember that colon cancer screenings are now covered by most insurance plans as a preventative measure for average-risk populations. If you’re still reluctant about the test, talk to your SoFHA physician about other screening options that are available. It could save your life!