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I keep our medications in the obvious place - behind the mirrored door of the medicine cabinet in the bathroom. But I was wondering lately whether this is the best place for them, as we take baths and showers, and the room gets hot and steamy. Should pills be kept somewhere else?
Judy Siegel-Itzkovich comments:
You are right. A recent study by the University of Alabama at Birmingham has found that the most common place where Americans keep medications is their bathroom medicine cabinets. But UAB pharmacist Jackson Como, who is head of the university's drug information service, says that the bathroom medicine cabinet is the worst place to keep both over-the-counter and prescription drugs due to heat, moisture and humidity in the bathroom. Store medications in a cool, dry place such as a closet, out of direct sunlight and on an upper shelf, and out of the reach of children. Heat and moisture hasten the deterioration of medications, he adds, causing them to lose potency. Deteriorating drugs don't provide the full beneficial effect for which the drug was intended.
I have a sleep problem and asked my health fund doctor for a referral to the Technion's sleep lab in Haifa, but he said he doubted the clinic could help with my particular problem, so he didn't send me. My problem is that most of the time I can fall asleep, but I wake up after an hour or two. From then on, I get very little or no sleep. I do not want to take sleeping pills, but I cannot function on so little sleep. Can I get help, and where? H.S., Haifa area
Technion Prof. Peretz Lavie, one of the country's leading sleep medicine experts and a founder of its network of sleep labs, comments:
I was saddened to read your letter. Throughout the world, sleep medicine is considered a legitimate specialty. The Technion's Sleep Medicine Center has five laboratories in Israel and is a partner in eight clinics in Boston that were modelled after the clinical service developed here. Two of the leading hospitals in the world, Beth Israel Hospital and Brigham and Women's Hospital in Boston, adopted the Israeli model. But sadly, as the Bible says, "there is no prophet in his own town." I am not sure if we can help you if you are referred to our clinic, but for your doctor to refuse to refer you because he doubts we can help you seems to me a disservice.
As for your question, falling asleep easily but waking up after a few hours may be caused by several factors such as anxiety, tension, mood changes or organic reasons such as abnormal motoric behavior in sleep (restless legs syndrome, for example), or breathing disorders during sleep. It is impossible to reach a proper diagnosis of such a sleep disorder without examining the patient. Once the problem is diagnosed, you can get help. You can tell this to your doctor and ask again for a referral to a sleep lab.
I have a most embarrassing problem. I seem to be losing control of my "anal windpipe" and have bursts of sound at any given moment, usually without warning. I am 75-years-old, have a constipation problem and have to take an herbal capsule or laxative tea every second night. I eat a lot of salads, fruit, vegetables and chicken. I am desperately in need of help. H.C.G., Tel Aviv
Judy Siegel-Itzkovich replies:
You should first see your family doctor, who will probably refer you to a gastroenterologist to see if you have any medical problems behind your "embarrassing problem"- including what is causing your constipation. If you have a clean bill of health, the Mayo Clinic Health Letter has written advice for people like you. There are over-the-counter pills to reduce gas. Dietary changes could help. Try avoiding these foods one at a time to see if the gas subsides:
Dairy products: lactose, a sugar in dairy foods, is a common cause of gas. If you are sensitive to lactose, you may be able to tolerate yogurt and aged cheeses. Certain vegetables: dried beans and peas, cabbage, radishes, onions, brussels sprouts, cauliflower and broccoli contain certain carbohydrates that can produce gas. Excessive fruit sugar: prunes, apples, raisins and bananas, as well as prune, apple and grape juices can be bothersome. Excessive fiber intake: decrease your intake of bran and other high-fiber foods. Slowly add them back to see how much you can tolerate. Sorbitol and mannitol: these artificial sweeteners are found in some sugar-free products. High-fat foods: fatty meats, fried foods, some sauces and gravies can cause gas. Carbonated and sparkling beverages: avoid these beverages. And eat slower to avoid swallowing air.
Rx For Readers welcomes queries from readers about medical problems. Experts will answer those we find most interesting. Write Rx For Readers, the Jerusalem Post, POB 81, Jerusalem 91000, fax your question to Judy Siegel-Itzkovich at (02) 538-9527, or e-mail it to firstname.lastname@example.org, giving your initials, age and residence.