A DECADE LATER

58 years old! It has been a decade since I was first diagnosed with lupus. I have fared well. I can play tennis, cook a holiday meal, dance to the golden oldies, decipher fact from fiction and write blogs. I am doing better than I was a decade ago and finally emerging from a semi-coma. Well, not literally but that is what it feels like.

I can talk easily again – at a regular speed and at an audible level. The speed of my thinking has increased so significantly I have had to ask friends whether they think I am becoming manic. They have assured me that I have just become normal again.  In comparison to a few months ago, I am quick with the wit, aware of my surroundings, and more perceptive of my feelings and those of the people around me.  I am interrupting people less because I can remember what I want to say until after the other person has finished speaking.  

Being able to experience emotions again does come with a downside.  It does hurt more when a “friend” tells you that she thinks that you are a hypochondriac.  Doesn’t she understand that all of these weird health problems happen to someone with lupus? And when your sister and children blame you for their problems, you feel the rejection and anguish.

Experiencing grief and anger is so much more intense.  My blood boils because my oldest sister has been medically neglected in a “care facility” - this has literally raised my blood pressure. And my discomfort at being hoodwinked into believing the prescription drugs provided benefits that were worth sacrificing the joy of sex for so many years is strong. There is safety in being drugged into “unfeeling” but it means that you miss out on the essence of life.

And then there is the perception of time. This seems paradoxical but time has slowed down. Maybe it is because I have so many more hours in the day because I am not sleeping and I am so more efficient in everything I do. The thought of being bored has even crept into my mind.  

So for now, I will go back to my blogging. I will try to ignore that most of the people I know don’t want to be hear about healthy living.  I will attempt to tone down my level of proof provided to augment my arguments and let my sources speak for themselves

My next blog discusses how I emerged from what was thought to be lupus fog.

 

Salt in the wound? Government won’t support legislation to reduce sodium consumption

Salt in the wound? Government won’t support legislation to reduce sodium consumption.

This position of the Canadian Health Minister is incredibly foolish! After all of the support from industry, doctors, Health Canada officials in favour of this action, how can she vote against it? When she became the minister surely she was told that her responsibility was to look after the health of Canadians. If she swore to fulfill this duty and now has changed her mind then she should resign. If you want to see more information about the dangers of salt go to my blog Sue's Lupus Blog "Is the Salt in Your Diet Killing You?"http://howtosurvivelupus.blogspot.com/

BE AWARE OF MEDICATIONS CONTAINING ACETAMINOPHEN

PRODUCTS CONTAINING ACETAMINOPHEN

                                                               
 

Which one of us does not pop a pain killer when we have headaches, arthritis pain or sore muscles? How about when we have coughs, colds, the flu, allergies, fever, or tooth aches? It is very prevalent for people with lupus, along with all of those healthy people, to take over-the-counter medication. But did you know that you are at risk of serious health problems from taking medicines containing acetaminophen (ACET).

Taking too much acetaminophen can cause liver damage - sometimes serious enough to require liver transplants or cause death. ACET is the leading cause of liver failure in the US.  It sends 56,000 people to emergency rooms each year. Half of those people unintentionally overdosed.

 And just how easy is it to exceed the daily limit of 4000 mgs? Extra strength Tylenol contains 500 mgs of acetaminophen and regular Tylenol contains 325 mgs. Some medicines including ACET contain 650 mgs or even 1000 mgs. In the case of Extra Strength Tylenol , If you follow the dosage instructions of up to 2 tablets every four hours you would consume 6000 mgs (150% of the daily limit) thus overdose.

The Federal Drug Administration working group reviewed the FDA adverse event data base and a large liver failure study and found the liver damage occurs in the range of 5000 – 7500 mgs in 24 hours. The working group recommended that the daily limit be reduced to 10 regular pills (3250 mgs) a day. This  recommendation has not been implemented.

Acetaminophen is known by many other names (APAP, N-acetyl-para-aminophenol, and paracetamol.) It  is widely available in more than 200 medications.  It  is also contained in prescription pain medications such as Vicodin, Percocet , and Oxycodone that are widely used.  In one year, 200 million prescriptions containing acetaminophen were dispensed in the U.S.

 The fact that so many medicines contain acetaminophen increases the danger of an overdose.  “The risk of liver injury primarily occurs when patients take multiple products containing acetaminophen at one time and exceed the current maximum dose of 4000 mgs within a 24 hour period “said Dr. Sandra Kweder, the FDA’s deputy director for new drugs.

Tylenol is just one of 44 brand names of acetaminophen. Additionally, it is found in medicine combined with other drugs.  Some names you may recognize are some forms of Robaxcet  Anacin, Alka-Selzer ,Dimetapp, Sudafed, Dayquil,  Dristan, Robitussin, Excedrine. Midol PMS, Vicks 44 ….. For a complete list see the MedPlus website cited at the end of this blog.

Another consideration is consuming ACET while using alcohol or drugs. It increases the risk of liver damage especially amongst older people who have a lower ability to clear drugs from their systems. For those who consume alcohol regularly, the daily limit of ACET is 2000 mgs a day.  This works out to 4 Extra Strength Tylenol a day.  Some doctors recommend that you should not use alcohol when using any over-the-counter or prescription medicines.

According to the FDA if you drink 3 or more alcoholic beverages a day you should consult with your doctor about a safe dose of ACET. I may be naïve but I think that heavy drinkers are unlikely to bring this up with their doctors. But just think of all the heavy drinkers that take Tylenol for hangovers! The damage caused by ACET is more likely to occur when it is taken after alcohol is metabolized.

Even one overdose of acetaminophen can cause permanent liver damage. Call poison control as soon as possible, in case of an overdose. There is an antidote named N Acetycystein which is most effective if  taken within 8 hours of ingesting the ACT.  Don’t hesitate even if you feel well. The symptoms of an overdose may not appear for up to 24 hours. They include abdominal pain, nausea, vomiting, not feeling well, unable to eat, and a poor appetite.

WHAT ABOUT SAFEGUARDS?

Reducing the amount of ACET in medications

Due to evidence linking it to liver failure, the American Food and Drug Administration has capped the amount of acetaminophen to 325 milligrams per capsule in prescription painkillers. However, they have not followed the recommendations of the FDA working group to also lower the dose of acetaminophen in the over-the-counter products. 

Labeling

4000 mgs is the stated limit on Tylenol bottles but that leaves little margin for safety. There is no mention of permanent liver damage caused by exceeding the limit. This dosage instructions would be more explanatory if it read “1-2 tablets every four to six hours but not to exceed  8 tablets a day or permanent liver damage may occur in a healthy adult.

 In Canada there is no requirement to place warnings on bottles of extra strength ACET. However,  in 2009, Health Canada issued  a voluntary warning for ACET bottles. It reads” taking more than the maximum daily does may cause severe or possibly fatal liver damage.”

Monitoring and Education

Have you been questioned about what over-the-counter medications you take? I haven’t. The prescription information sheets issued with your prescription says that you should inform your doctor or pharmacist of all of the prescriptions and over-the-counter medicines you take. Without this information just how are pharmacists able to monitor drug interactions?

 Given the potential for unintended abuse, it would be appropriate for doctors to question and warn their patients about the risks of using too much acetaminophen and for pharmacists to warn patients particularly those with chronic pain conditions.  What could be even more effective would be to have all purchases containing ACET rung through the pharmacy till so people can be warned about the dangers of overdosing when using multiple medicines.

SO REMEMBER, the next time you are buying over-the- counter medication, be sure to check the label closely and ask the pharmacist about interactions with your prescriptions.

                               

SOURCES:

http://www.emedicinehealth.com/acetaminophen_tylenol_poisoning/article_em.htm

 http://www.nim.gov/medlineplus/druginfo/med/a681004.htm

 http://www.rxlist.com/tylenol-drug.htm

www.agingincanada.ca/dangers_ of_ acetaminophen.htm

http://www.hc-sc.gc.ca/dhp-mps/prodpharma/applic-demande/guide-ld/label_stand_guided_ld-eng.php#a6-1

Is Sugar Toxic?

IS SUGAR TOXIC?

Yes, according to the new research reported on 60 Minutes,  April 1st, 2012. I'd like to think it was an April Fool's Day prank but no such luck. This is a big problem for my sweet tooth! It is now explainable though, since sugar is as addictive as cocaine. Now that I know the truth about sugar, I am going to cut back on it and avoid consuming 130 pounds annually - like the average American.

Where did all of this sugar come from? Well, in an effort to reduce heart disease the food industry removed fats from food and replaced it with sugar (to maintain the flavor). What has transpired? Heart disease has skyrocketed along with cancer, Type 2 diabetes and obesity.

But why is sugar toxic? Sugar increases LDL (as in the blood vessel blocking type); it causes insulin to spike; and it feeds the growth of some cancers.

It would be nice if it was possible to replace sugar with say, honey. However, according to the "experts" all sources are equally bad.  For more info go to: www.cbsnews.com/8301-18560_162-57407294/is-sugar-toxic/

IS THE SALT IN YOUR DIET KILLING YOU?



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We have all probably heard that eating salt causes high blood pressure! But is it a big deal? A recent MSN news story stated that 800,000 Americans die each year due to diseases related to high blood pressure ((kidney disease, heart disease, and strokes).

The US Centres for Disease Control and Prevention found that 9 out of 10 Americans exceed the Tolerable Upper Intake Level (UL) of 2300 mg. This is the standard adopted in North American as the highest intake level that is likely to pose no risk of adverse health effects. It is equal to 1 teaspoon of salt a day.

Canadians are no different from their southern neighbours. The average Canadian eats more than 3400 milligrams of salt daily. Even without adding salt to food, it is there in our diet.

Only 1500 mg of salt is needed daily to support health. Sodium is needed in the body to regulate fluids and blood pressure, and to keep muscles and nerves running smoothly. People with high blood pressure, kidney disease, diabetes and over the age of 50 years should be adhering to an upper limit of 1500 mg.

 So we think we are okay because we don't add salt to our food and rarely snack on chips... But did you know the biggest source of salt is bread and buns. Not because it contains the most salt but we eat several servings each day that add up. According to a US study Americans get 44% of their salt from the following foods which are listed from the highest salt source to lowest: bread and buns, cold cuts and cured meat, pizza, poultry, soups, hamburgers, sandwiches, cheese, pasta dishes, meat loaf, chips and pretzels. The processed foods and restaurant meals contain even more salt than usual.

I am a little embarrassed to admit the food in the picture above came from my kitchen.

• The bagel contains 390 mg (or 26% of the daily value) based on limit of 1,500 mg a day.
• The can of mushroom soup contains 2250 mgs of salt which is well over the tolerable upper limit for my age group. When you look at the label on the can it states the sodium % based on the serving size and daily limit of 2300 mg. But this label in my opinion is misleading. The serving size is a ½ cup of soup. I don’t know about you - but I eat most, if not, a whole 10 oz. can of soup.
• Even the Healthy Choice – Chicken with Rice Soup contains 960 mg in the can of ~ 2 cups and according to the label it contain 40% less sodium that leading competitors. It is interesting to note that American Heart Association put its sign of approval on this can of soup. In the small print it states the food meets their criteria for saturated fat and cholesterol healthy people for children over the age of 2.

That reminds me of a Fifth Estate program I saw about sodium. The chief nutritionist of the Canadian Heart and Stroke Foundation was questioned why she would be recommending canned soups with high sodium levels. I can’t find the documentary in the CBC archives so it must have been a number of years ago. However, I clearly recall hearing that packaged foods in Canada have a higher content of salt than American foods. I was flabbergasted to hear the food manufacturers had somehow decided that Canadians had bigger appetites for salt and demand it! You have to wonder if this is still the case.

Governments are now looking at ways to influence the sodium content of Canadian and American diets. In the U.S. they predict they can save billions of dollars in health care costs if they can reduce the average sodium intake by 20%. In Canada, they have set a goal to reduce the average Canadian consumption of sodium to 2300 mg by 2016.

• You may hear some people saying that the government has no role in their food choices. Remind those people that they can always get out the salt shakers and add extra salt to their food, if health is not a consideration.

 In the meantime, we can choose to avoid certain manufacturers that add too much sodium to their products. From what I have seen with Campbell’s soup, this may be one place to start. And remember to read the labels to find food that is truly sodium- reduced, not just advertised as such.  

Government Regulations of BPA

GOVERNMENT REGULATION OF BPA

CANADA:

• In 2006, the  Chemicals Management Plan was introduced to review the safety of widely-used chemicals that have been in the marketplace for many years, and to update our knowledge and understanding of these chemicals.

•  In 2008 Canada banned baby bottles containing BPA. They also proposed declaring BPA toxic because of reproductive and developmental toxicity and environmental effects.

• On October 13, 2010, BPA was declared a toxic chemical by the Canadian government and added it to Schedule 1 of the Canadian Environmental Protection Act.  Canada was the first country to make this declaration.

•  The American Chemistry Council, a Washington- based industry group criticized Canada’s decision. This lobby group speaks on behalf of a $10B a year industry.

•  On December 2, 2010 (less than 2 months later) Health Canada backed down and published this statement “exposure to BPA though food packing is not expected to pose a health risk to the general population, including newborns and infants”

UNITED STATES:

• The FDA approved the use of BPA in the 1960s. And in 1976, BPA was included in a list of more than 60,000 chemicals deemed safe by the US Toxic Substances Control Act

•  In 2008, a National Toxicology Program at the Department of Health and Human Services said it had "some concern" about the possible health effects of BPA on the brain, behaviour and prostate gland of fetuses, infants and children. Nonetheless, months later, the FDA said the chemical was completely safe.  Subsequently, the FDA review board rejected this conclusion.

•  In January 2010, the FDA released a new statement, saying that BPA is of "some concern" for infants and children. Around this time, the Obama administration announced $30M in funding to “answer key questions about the chemical that will help determine what action, if any, is necessary to protect public health.”

•  The FDA was sued in July 2010 by the Natural Resources Defence Council for failure to respond to their petition with 18 months as required by law. This petition called upon the FDA to ban the use of biphenyl A (BPA) in food packaging, food containers, and other materials likely to come into contact with food.

•  The court decision was released in December 2011 which called upon the FDA to make a final decision about BPA by March 31, 2012.

OTHER COUNTRIES:

• In December 2010, the European Union (EU) passed legislation that requires testing and classifying chemicals before they can be put into products.

•  On May 31, 2011, the EU banned the sale of baby bottles containing BPA.

• China and the European Union have enacted legislation prohibiting and restricting the use of endocrine disruptors (including BPA) in commercial products.

                                             

My next blog on BPA presents an overview of the plethora of research done on BPA. Some scientists have been working on it for more than 20 years and they are calling for public input to move the politicians. Someone has to speak up for our environmental health and we need to counter the lobby group for the chemical industry.

BPA IS TOXIC - HOW DO WE AVOID IT?

BPA (bisphenol A) is a polycarbonate chemical used in consumer and medical products to soften plastics. BPA was declared a toxic chemical by the Canadian government in October 2010.

You will still find it in:

• the coatings of canned foods
•    plastic bottles
•    plastic food storage containers and baggies
•    Beverage containers  
•   baby toys
• aluminum cans ....

I know BPA has been in the news for years and many of us have just assumed that something has been done about it already. Well, it is no longer in baby bottles in Canada and some reputable manufacturers have removed it from some beverage containers.  You will recognize the beverage containers because they have BPA free symbols on them.  If there is no symbol on the bottle, assume that it contains BPA. 

BPAs have been found in 90% of Canadians and 93% of Americans (according to studies).



JUST HOW CONCERNED SHOULD WE BE?

Many studies have been done on “our friends” the lab rats over the years and the studies have moved onto the correlation of BPA and disease states in humans in recent years. Here is the long list of harmful effects mentioned in the literature:

 

• Impaired, altered, and compromised immune system and functions
• Cancer (breast, prostate, and uterine)
• Cardiovascular disease
• Diabetes
• Asthma
• Behaviour problems
• Hyperactivity
• Increased aggression
• Elimination of sex differences in behaviour
• Anxiety and depression in female children
• Impaired learning and memory
• Liver abnormalities  
• Reproductive disorders 
• impaired female reproductive development and miscarriage
• Lower sperm counts and sperm defects
• Chromosome abnormalities
• Down’s , Turner and Klinefelter Syndromes

I am worried. Are you ?

When you look at this list you have to wonder whether BPAs are responsible for the increase in lupus and other autoimmune diseases. Does BPA play a role in what seems to be increasing cancer rates in younger age groups?  Could BPA be the main culprit in the increased incidents of aggressive, violent behaviour in females and increasing behaviour problems in children. And how about the decreasing performance of boys in schools?
 

 JUST HOW DO WE PROTECT OURSELVES?

•          Buy foods in glass jars and store foods in glass containers, porcelain or stainless          steel containers. 
•         Never buy plastic water bottles especially in hot climates. Heat increases the release of the toxic chemical. Just think how much heat those plastic bottles have been exposed to when transporting them or while sitting in your car. 
•         Buy BPA free beverage containers. 

I just bought a BRITA BPA free water bottle (officially the Bottle Water Filtration System) to carry filtered water to the tennis courts, the gym and outside activities. Drinking sufficient water is critical to health of the kidneys - a very important consideration for people with lupus.

The Washington Post published an article announcing the EAU good water bottle will be hitting American stores later this month. See blackandblum.com for more info about this charcoal-filtered water bottle.

•         Eat homemade soups or those stored in tetra paks. Yes, the tetra paks are not good for the environment either but at least you are not being exposed to a toxic chemical.
•          Don’t heat up plastic containers – either in the microwave or the dishwasher (despite what the American Chemistry Council might say).
•          Don’t eat canned foods if you can avoid it. Most cans contain PBA.
•        Do not use plastics including shopping bags which are releasing BPAs into the environment from landfills.
•         If you must occasionally use plastic, recycle it.

WHERE ARE THE GOVERNMENT PROTECTION AGENCIES IN REGULATING THIS TOXIC CHEMICAL?

Well, that is another topic in itself – find out in the next blog.