DEAR DR. ROACH: I’ve an excellent pal who is nearly 77 years previous. He was a heavy smoker till about 14 years in the past. He determined to stop smoking and used nicotine gum to assist with this course of. It’s my understanding that nicotine gum ought to solely be used for a reasonably brief time period to assist an individual stop smoking.
However, he’s nonetheless utilizing it a number of instances a day and freely admits that he’s “addicted” to it. What form of detrimental well being influence can this have on him? — J.Okay.
ANSWER: I usually hear folks notice that therapies like nicotine alternative, methadone, or related medication for opiod use dysfunction is “buying and selling one habit for one more.” However, this isn’t a useful method of it as a result of smoking has very critical penalties on an individual’s well being, whereas nicotine alternative has comparatively minor antagonistic results.
The most typical antagonistic results of nicotine-replacement remedy included coronary heart palpitations, nausea, vomiting, different gastrointestinal complaints, and insomnia. Nicotine gum specifically may cause mouth and throat soreness, mouth ulcers, and cough or hiccups. Compared to the various well being issues of smoking (coronary heart illness, many cancers, lung illness), nicotine alternative is dramatically safer.
The purpose of remedy on the subject of nicotine use dysfunction is to cut back well being dangers. While being freed from smoking with out utilizing nicotine alternative is healthier, I’d congratulate your pal on quitting and sticking to it after so a few years.
DEAR DR. ROACH: Sadly, my brother (73) has failing kidneys, and his physician says he might want to go on dialysis quickly. He additionally mentioned Farxiga is not going to assist his kidney issues, however why wouldn’t it? Being his brother, would I be an acceptable kidney donor for him? — B.F.
ANSWER: There are many causes of continual kidney failure, however as soon as the kidneys attain a sure level, dialysis or transplantation turns into inevitable to supply an extended and higher high quality of life.
Dapagliflozin (Farxiga) is among the SGLT-2 inhibitors, which work by stopping the kidney from having the ability to reabsorb sugar. It is particularly helpful for kidney illness related to diabetes, however additionally it is helpful in folks with the form of kidney ailments that has excessive quantities of protein within the urine. So, it might be that dapagliflozin was prescribed too late to assist, or he could have one of many sorts of kidney failure that isn’t related to protein within the urine.
Since you might be his brother, there’s a good probability you could be a suitable kidney donor. Kidney transplantation would give your brother the very best quality and size of lifetime of all of the therapies we’ve for end-stage kidney illness. Having a living-related donor bypasses the lengthy ready checklist for a cadaver kidney.
However, there may be not a assure that you just two are appropriate. In addition, he must be in in any other case good well being. Furthermore, some facilities have an age restrict on donation, and it’s good to be in good bodily situation. You ought to communicate together with your brother’s kidney specialist a few referral to a transplant program. They will counsel you in your dangers in changing into a donor.
Dr. Roach regrets that he’s unable to reply particular person letters, however will incorporate them within the column every time attainable. Readers could e-mail inquiries to ToYourGoodHealth@med.cornell.edu or ship mail to 628 Virginia Dr., Orlando, FL 32803.
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