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Ask the Sioux City doc: Answers to your questions about blood pressure medicine, weight loss and more

Ask the Sioux City doc: Answers to your questions about blood pressure medicine, weight loss and more

Dr. Robert Andrews

Robert Andrews

Is there a home remedy or “over-the-counter” cure for nail fungus?

There are several over-the-counter medications for nail fungus or “onychomycosis," the most popular of which seems to be Lamisil, which is topical terbinafine. The issue with topical treatment is it can take a long course of treatment to be effective, and it only has a cure rate of 40-75%. If it is a moderate or severe case, seeing your primary care physician for evaluation and possible prescription of an oral medication can bring faster and better results.

Is it dangerous to eat grapefruit when taking certain medications?

Yes, it can be. Many drugs are broken down in the liver and intestines using an enzyme called CYP3a4. When you eat grapefruit, the fruit interacts with this enzyme and decreases its activity. This means drugs that are normally broken down by that enzyme stay in your system longer. Types of drugs that can be affected include statins for cholesterol, blood pressure medications, certain allergy medications and some immune suppression drugs for autoimmune disorders. Check with a doctor or pharmacist before eating grapefruit if you are taking medications.

Where does food go when it goes down “the wrong way”? Does it end up in your lungs? If so, what happens?

When you swallow, food goes down in your throat through a large opening that very quickly divides into two separate tubes.  In the back is your esophagus, a soft tube that leads to your stomach and where food normally goes down. In the front is your trachea, which has hard, C-shaped rings of cartilage that you can feel when you touch the front of your throat.  Normally there is a flap called the epiglottis that, when you swallow, closes over the opening to the trachea and keeps food from going down into your lungs.  However, when food goes down the "wrong pipe," it means some food is able to get past the epiglottis and into the trachea.  When this happens, it triggers cells in your trachea are that are very sensitive, and causes a strong coughing reflex that normally blows the food back out of your trachea and out of your mouth.  However, sometimes food is able to get deeper and one of a few things can happen. In some cases, small particles and food that get deeper are absorbed through the cells or moved up and out of the trachea by little fingerlike extensions that line the cells of the trachea. On other occasions, if the individual is weakened and does not have a strong cough reflex, the food can become lodged in the lower parts of the long become a source for infection, which can lead to what is called an "aspiration pneumonia."

What is the best time to take blood pressure medicine? Morning or night?

Some blood pressure medications are taken twice a day, but for those taken once a day, some studies have shown that there is a small decreased risk of heart attack, stroke, and heart failure when the blood pressure medications are taken at night. Also, because you are sleeping when the medication becomes most active, there are potentially fewer side effects from lowering your blood pressure, including dizziness and lightheadedness. However, the most important part of taking a blood pressure medication is consistency, so whenever you can remember to take it -- either morning or night -- is the best time.

If someone in your family gets COVID-19, how do you make sure others don’t? Are you just doomed to get it? Or do you need to sequester the person in a room? I’m worried about cleaning every surface the person touches. And how soon after can we assume the person isn’t going to give it to someone else?

If someone in your family gets COVID-19, you are not doomed to get it, but it will take a large effort on everyone's part to ensure that it does not get transmitted. The easiest way to avoid getting it would be to have the individual who tested positive isolate in another location so as not to infect others, but this is not always possible with family members.

CDC guidelines recommend isolating the individual who tested positive in a section of the house, away from the rest of the family, if possible, with a separate bedroom and bathroom. Family members who have not tested positive should try to remain 6 feet away from the positive individual. Be sure to eat in separate areas, and do not share personal items. If you need to interact with the sick individual, have him or her wear a mask to avoid transmitting the virus.  Be sure to wash your hands and clean all frequently touched surfaces daily.  Try to avoid touching trash and laundry from the infected individual and be sure to wash your hands after doing so.  Current CDC recommendations for return to usual interactions is a minimum of 10 days after symptoms developed, and 72 hours fever-free without use of any fever-lowering medications, and improvement of symptoms.

The CDC also recommends the individuals who are caring for a person who is sick stay home and monitor for symptoms of infection. It also recommends self-isolating for 14 days after the last contact with the sick person, or 14 days after the sick person meets the criteria to end home isolation.

How much walking do you need to do to lose weight? A friend said she lost a lot just by walking a couple of miles each night. Is that enough?

The key to weight loss is calories in versus calories out. Increasing daily exercise is one way to lose weight. Approximately 30 minutes or more of activity 5 to 7 days a week is a good start toward weight loss and overall health. In all likelihood, your friend combined walking with modest diet changes.


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