The Health Blog

ARTHRITIS AND CORTISONE: THE DISCOVERY OF CORTISONEIt all started at the Mayo Clinic as recently as 1949. In that year, Dr. P. Hench and Dr. E. Kendall—with their associates Dr. C. Slocumb and Dr. H. Polley—startled the entire field of medicine with their discoveries on the uses of “man-made” cortisone.When the announcement of their important findings was made, I immediately boarded a plane and flew out to the Mayo Clinic in Rochester, Minnesota. I could not imagine or believe that a synthetic substance could perform “miracles” for arthritic bodies.By making this trip to Minnesota, I was present at the Seventh International Congress on Rheumatic Diseases held at the Mayo Foundation. After hearing testimony on cortisone, I still did not believe that this drug was the complete answer to arthritis. It is not a permanent cure, and the past few years have proved that I was right.It is true that in certain kinds of arthritis, cortisone can turn off the pain within hours. But the relief is often temporary. Another advantage of taking cortisone is the fact that some chronic rheumatoid arthritics were then able to do exercises. By using their muscles, they were able to prevent wasting away and minimise crippling. Again, this gain was frequently nullified by relapses.Cortisone, taken orally or by injection, does have an anti-inflammatory effect. For some rheumatoid arthritics it does lessen their joint stiffness, heat and swelling. But reports now indicate that some 85 per cent, of the cases later suffer relapses. And cortisone manufactured commercially has little or no effect whatsoever on osteo-arthritis.Any person or any chemical bringing even temporary relief deserves our thanks. Congratulations are in order to the doctors who developed cortisone and its uses. The only unfortunate fact is that cortisone does not bring lasting recovery.And we must add a definite warning that taking cortisone by prescription can cause a number of harmful reactions throughout your body. It may help arthritis, but irritate other tissues and organs.*52\146\2*

DOES RITALIN HAVE ANY SIDE-EFFECTS?Ritalin is widely considered to be a very safe drug, but as with any chemical compound, certain side-effects may result. Many children, for example, experience a decrease in appetite while the drag is in their systems. That’s why the first dose of the day is usually given with breakfast or immediately after. Because of this effect, many children are exceptionally hungry at dinnertime, when their second daily dose has worn off.In addition, some youngsters experience a slight weight loss during the first few months they’re on Ritalin. In most cases, weight stabilizes after a short period and then begins to increase again. If a child is overweight, this drop can be a good thing and very beneficial to his self-esteem.Another common problem associated with Ritalin use is mild insomnia. This effect usually disappears within a few weeks. If it continues, reducing the second daily dose or giving it to the child earlier in the day may help. In extreme cases, a morning dose may be all that a child can handle.Other possible side-effects include the following.Headaches or abdominal problems at the beginning of treatment. In most cases, these problems disappear within a few days.Tearfulness and lethargy. Some children become very emotional or overly subdued when on Ritalin, which suggests their dosages are too high. Very sensitive children often see dramatic improvement on a very small dose of the drug. Others require and are able to tolerate much higher amounts. In some cases, determining the proper dosage for a child involves close monitoring and more than a little trial and error. However, the side-effect of depression might also call for a change in medication. Often Cylert or Dexedrine can have a very different effect.A worsening of facial tics or other involuntary twitches. However, many children find that their tics disappear when they’re on Ritalin. Every child is different, and their reaction to the drug will be different too. If a child’s tics worsen greatly, he should be taken off Ritalin and given an alternative medication, such as clonidine.The development of psychosis. Actually, this side-effect is so rare that it barely deserves mention. Only thirty cases of stimulant-induced toxic psychosis have been reported in the mainstream medical literature. Nonetheless, it’s something your child’s doctor should be aware of. Other extremely rare side-effects include alopecia (loss of hair) and hypersensitivity reactions such as fever, skin rash, dermatitis, angina, and erratic heartbeat.An increase in sudden seizures. Stimulants tend to lower a person’s seizure threshold. The good news is that recent studies have found that stimulants and anticonvulsants can be given simultaneously with no reduction in effectiveness. However, blood levels of anticonvulsants should be checked frequently to prevent toxicity resulting from Ritalin’s ability to boost blood levels of both drugs.Because Ritalin, Dexedrine, and Cylert are all stimulants, many parents worry that their children will become addicted to the compounds much like someone becomes addicted to cocaine or methamphetamine. However, numerous studies have shown that Ritalin, especially, is not addictive when used as directed and under a doctor’s supervision. In fact, many parents have the opposite problem—getting their children to take their medicine!It’s true that some studies suggest children with ADHD are at greater risk of developing an addiction problem later in life, but this is usually a personality disorder unrelated to Ritalin use in childhood.*52\173\2*

WHAT MAKES BDD BETTER OR WORSE: PROBLEMS WITH APPEARENCEPeople with acne typically say that their preoccupation gets worse when their acne flares. Compulsive hair cutters typically feel worse after a hair-cutting binge, and skin pickers usually feel worse after picking. Many women say their symptoms worsen premenstrually. While social situations can make BDD symptoms more painful for many people, occasionally they’re largely limited to social situations. As Zach explained, “When I’m by myself, my symptoms are hardly there. But as soon as I’m around people, I think they’re aware of my mouth, and I’m no longer rational. I think that other people are noticing my lips. I become obsessed and anxious, and my rational thinking about them goes out the window.” Social situations significantly worsened Zach’s symptoms and also decreased his insight into their irrational nature.It can be helpful to avoid some of these exacerbating factors—for example, comparing with others and looking through magazines at attractive people. But you’re better off facing some of them, such as social situtions. In the long run, you’ll feel better if you expose the defect, if possible, and go to social events.*201\204\8*