Healthoughts

Healthoughts compiled by Jon Nalick

Illustrations by Diane Bigda.

errant herbs

many americans take herb supplements to boost their health but they may not realize that continuing to do so prior to surgery could have life-threatening results.

James D. Adams, Ph.D., associate professor of pharmacology at the USC School of Pharmacy, says that a great number of commonly used herbal supplements interact with anesthetics and other drugs used during surgery. Those interactions can trigger potentially disastrous surgical complications, including excessive bleeding, an inability to breathe and racing pulse rates.


“For example, people use garlic capsules to control blood pressure and
cholesterol, but taking them before surgery can cause serious bleeding, and even deaths have been reported,” Adams says.


Other herbal supplements that can cause bleeding problems include ginkgo biloba, ginseng and ipriflavone.
The herbal sedatives valerian and kava can both interact with anesthetics and interfere with breathing.
Adams also urges caution with St. John’s wort, commonly used to treat mild depression.

“St. John’s wort has a huge number of interactions and problems. It can render birth control pills ineffective and, if taken with serotonin reuptake inhibitors, it can cause death. In surgery, it can interact with certain drugs to promote blood clots,” he says.

Adams stresses a special note of warning for anyone still using ephedra, also called ma huang, an herbal stimulant used for weight loss that increases the heart rate and blood pressure. The U.S. Food and Drug Administration banned ephedra in early 2004 because it was linked to significant adverse health effects, including heart attack and stroke.

Adams says that to be safe, the key is for patients to stop taking all herbal supplements at least a week before surgery. He says, “Patients should always discuss with their doctors which herbal supplement they are using, especially before surgery or when adding any new drug to their regimen.”

clear the ear

The production of earwax is a little-noticed bodily function—and, frankly, that is the way most people prefer to leave it.


But despite its rather useful way of trapping particulate matter and stopping it from moving deeper inside the ear, earwax can build up in amounts large enough to impair hearing.

Dale Rice, M.D., chair of the Depart-ment of Otolaryngology and the Leon J. Tiber and David S. Alpert Chair in Medicine at the Keck School of Medicine of USC, says that most people shed earwax—also known as cerumen—as routinely and imperceptibly as they shed skin.

But for others, the special sweat glands in the ear canal produce the sticky wax faster than the body’s self-cleaning mechanism removes it. The resulting buildup can cause earaches, a sensation that the ears are plugged and hearing loss, he says.

Rice says that the most common method of cleaning the ears—using cotton swabs to dislodge the wax—is probably the most dangerous, promoting infection and accidental damage to the ear’s structures. He also cautions that earwax should be removed only by a physician if there is ear pain, discharge, a suspected ruptured eardrum, prior ear surgery or tubes in the ears.

“There are self-treatments such as softening the wax with warm mineral oil and over-the counter products,” he says. “But it is best to first let your physician determine if you have excessive earwax, then proceed with a treatment.”

kid carbs

With a low-carbohydrate craze sweeping the nation, parents may reasonably wonder whether an Atkins-type diet may be suitable for overweight children.


Carol Koprowski, Ph.D., R.D., assistant professor of clinical preventive medicine at the Keck School of Medicine of USC, says it is a far better idea to teach a child proper eating habits and encourage more exercise.

She cautions, “Severely limiting nutrients such as fat or carbohydrates can interfere with a child’s health.”

Too much fat or carbohydrates can cause obesity. But too little fat in the diet can stunt growth, while too few carbohydrates can throw the metabolism out of balance, hamper the body’s ability to burn fat efficiently and impair brain development at early ages.

Koprowski says that diets may cause children to become preoccupied with food and can teach them to eat what and when the diet requires instead of eating when hungry. That may predispose some kids to eating disorders.

“The key is to create a healthy home environment. Get kids to enjoy foods such as plain fruit or chopped veggies and avoid relying on fast foods or commercially prepared foods to meet dietary needs. Children model their behavior after adults, so whatever you eat, they’ll tend to see as normal,” she says.

Koprowski says children should get no more than 30 percent of their calories from fat and should eat diets rich with fruits and vegetables—fruit juices excepted, as they are high in calories and contain little fiber.

Another key factor in keeping a child healthy and trim is to encourage exercise. Koprowski says even children who eat a large amount of food will remain fit as long as they burn off the excess calories.

nose woes

Regardless of what starts a nosebleed- dry weather, allergies, trauma and too much nasal spray are the most frequent causes—pinching the nose and tilting the head back is not the ideal way to treat it.


Uttam Sinha, M.D., associate professor and vice chair and program director for the Department of Otolaryngology at the Keck School of Medicine of USC, says that pinching the nose closed at the base of the nasal bones for about five minutes is a good idea, but it is better to tilt the head slightly forward.

Tilting the head back, he explains, directs blood down the throat and into the stomach, which can become irritated and induce vomiting.

But tilting the head forward, Sinha says, drains the blood out of the nose so it is not swallowed. A somewhat grim bonus is that the person can tell just how much blood the injury is generating, which can help determine how serious it is.

Applying ice to the nose can help constrict blood vessels and staunch the flow of blood. And the over-the-counter nasal spray Afrin can help constrict the blood vessels further. (Ironically, over-use of the medication for more than two days can dry out the nose and cause nosebleeds.)

Sinha recommends that people who are susceptible to nosebleeds consider using saline nasal spray to keep the tissues moist as a preventive measure.

He also cautions that nosebleeds can signal serious problems, including high blood pressure, diabetes, high cholesterol and cancer, especially when the nose bleeds spontaneously and frequently.


“Nosebleeds that will not stop after about 10 minutes of pressure are probably worth a physician’s evaluation,” Sinha says.