Category Archives: Ask U.S. HealthWorks

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Are Blood Pressure Pills Addicting?

A high blood pressure reading is occasionally seen when someone comes in for an unrelated reason (sprained ankle, cough, VD). When I mention this to the patient and ask if they have had high readings in the past, the answer is often “Yes.” When asked if they were under treatment, the answer is too often “No.”

Now, one elevated blood pressure reading does not a hypertensive make. But often people have had several medical providers tell them their reading was “a little high.”

So, in a moment of curiosity, I ask, “Why not?” One surprising answer is the following: “Once you start, you have to keep taking them.” In a rare moment of clarity, I ask, “You think blood pressure pills are addicting?” I get a nod. It does seem reasonable from the dire warning to not stop your BP medication (deep serious voice), that you may not even want to start it.

So let’s talk about blood pressure and BP medications for a minute. Blood pressure is just a pressure, like in your car tire or your garden hose. What would happen if you have too much pressure in your tire or your hose? It pops. There, that’s most of what you need to know.

How do you make pressure go down? Let out some air, close the garden valve (or hose bib for those who like technical words). So BP medications work in some pretty common sense ways. Let some air out, is just another way of saying diuretic. By making you pee a lot, the pressure in your body is reduced – you can almost feel the pressure go down. Or we can slightly slow the heart rate, kind of like turning down the garden hose valve. Sometimes we want to make the heart beat less forcefully, making a smaller pump, if you will. There are a few other ways to turn down the blood pressure, but you get the idea.

So, are blood pressure medications addicting? No. They make your blood pressure go down and keep it lower as long as you keep taking the medication. If you stop taking your meds, your blood pressure will just go back up to where ever it would be if you didn’t treat it. Blood pressure is just maintenance, like changing your oil. It’s a good idea to keep changing your oil as long as you want your car to keep running. Your car is not addicted to oil changes – it will just run longer if you do them. Same with your heart. It isn’t addicted to BP meds – it just will run longer if you take them.

Generic BP pills are available, so they don’t need to be too expensive. They don’t make you tired or weak, give you headaches, or hurt sexual function. There are enough different types of medications that there is truly something for everyone.

But medications aren’t the only way to control blood pressure. It unfortunately often works out that the patient isn’t doing all the life changes that will get the blood pressure down. Sometimes the doctor doesn’t even tell you about this stuff.

If you lose 20 lbs. and start an exercise program, we can always stop the medications. Weight loss helps control blood pressure, along with sweating and reducing stress.

Blood pressure medications aren’t addicting or magic. They work in pretty straightforward ways. The next time you have a high reading, ask your doctor about specific treatment, whether it be medication, lifestyle or both. No sense walking around waiting for something to “go pop.”

– Dr. B

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Symptoms of heat illnesses

As the mercury soared this week in many areas around the country, our Dr. B was on ABC 15 Phoenix’s Sonoran Living where he discussed the symptoms of heat illness and what measures you need to take if you start experiencing them.  You can watch it here.

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Questions About Extreme Heat Answered

1.    What happens to the body as a result of exposure to extreme heat?
People suffer heat-related illnesses when the body’s temperature control system is overloaded.  The body normally cools itself by sweating.  But, under some conditions, sweating is just not enough.  Very high body temperatures may damage the brain or other vital organs.  Several factors affect the body’s ability to cool itself during extremely hot weather.  When the humidity is high, sweat will not evaporate as quickly, preventing the body from releasing the heat quickly.  Other conditions that can limit your ability to regulate your body temperature include old age, youth (ages 0-4) obesity, fever, dehydration, heart disease, mental illness, poor circulation, sunburn, prescription medications and alcohol use.

2.    Who is at the greatest risk for heat-related illnesses?
Those at greatest risk include infants and children up to age 4, people 65 years and over, overweight people or people on chronic medications or with chronic diseases.

3.    What is Heat Stroke?
Heat stroke is the most serious heat-related illness.  Body temperatures can rise quickly, sometimes in 10-15 minutes, as high as 106 degrees.  Death or permanent disability can occur if not treated immediately.

4.    Warning signs of a Heat Stroke
Warning signs may vary, but may include the following:

  • An extremely high body temperature (above 103  degrees F)
  • Red, hot and dry skin (no sweating)
  • Rapid, strong pulse
  • Throbbing headache
  • Dizziness
  • Nausea
  • Confusion
  • Unconsciousness

5.    What should I do if I see someone with any of the warning signs of Heat stroke?
If you see any of these signs, you may be dealing with a life-threatening emergency.  Have someone call for immediate medical assistance,while you begin cooling the victim.

  • Get the victim to a shady area
  • Cool the victim rapidly,using whatever methods you can.  For example, immerse the victim in a tub of cool water; place the person in a cool shower; spray him/her with cool water from a garden hose; sponge the person with cool water; or if the humidity is low, wrap the victim in a cool, wet sheet and fan him/her vigorously.
  • Monitor body temperature and continue cooling efforts until the body temperature drops to 101-102 degrees
  • If emergency personnel are delayed, call an Emergency room for further instructions.
  • Do NOT give the victim alcohol to drink
  • Get medical assistance as soon as possible.

6.    What is Heat Exhaustion?
Heat exhaustion is a milder form of heat-related illness that can develop after several days of exposure to high temperatures and inadequate or unbalanced replacement of fluids.  Those most prone to heat exhaustion are elderly people, those with high blood pressure and those working or exercising in a hot environment.

7.    Warning signs of Heat Exhaustion
The warning signs of heat exhaustion include the following:

  • Heavy sweating
  • Paleness
  • Muscle cramps
  • Tiredness
  • Weakness
  • Dizziness
  • Headache
  • Nausea or vomiting
  • Fainting

The skin may be cool and moist.  The pulse rate will be fast and weak, and breathing will  fast and shallow.  If heat exhaustion is untreated, it may progress to heat stroke.  Seek medical attention if symptoms persist more than one hour.

8.    What steps can be taken to cool the body during heat exhaustion?

  • Drink cool,nonalcoholic beverages
  • Rest
  • Take a cool shower, bath or sponge bath
  • Seek an air-conditioned environment
  • Wear lightweight clothing

9.    What are heat cramps and who is affected?
Heat cramps are muscle pains or spasms – usually in the abdomen, arms, or legs – that may occur in association with strenuous activity.  People who sweat a lot during strenuous activity are prone to heat cramps.  This sweating depletes the body’s salt and moisture.  The low salt level in the muscle causes painful cramps.  Heat cramps may also be a symptom of heat exhaustion.  If you have heart problems or are on a low sodium diet, seek medical attention for heat cramps.

10.    What should I do if I have heat cramps?

  • STOP all activity and sit quietly in a cool place
  • Drink a clear juice or sports beverage
  • Do not return to strenuous activity for a few hours after the cramps subside because further exertion may lead to heat exhaustion or heat stroke
  • Seek medical attention for heat cramps if they do not subside in 1 hour

11.    Can medications increase the risk of heat-related illness?
The risk for heat-related illness and death may increase among people using the following medications:

  • Psychotropics, which affect psychic function, behavior or experience (such as haloperidol or chlorpromazine)
  • Medications for Parkinson’s Disease, because the inhibit perspiration
  • Tranquilizers, such as phenothiazines, butyrophenones, and thiozanthenes
  • Diuretic medications or “water pills” because they affect the body’s fluid balance

12.    How effective are electric fans in preventing heat-related illness?
While electic fans may provide comfort, but they will NOT prevent heat-related illness.  Taking a cool shower or bath or moving to an air-conditioned place is a much better way to cool off.

13.    How can people protect their health when temperatures are extremely high?
Remember to KEEP COOL and Use common sense.  Drink plenty of fluid, replace salts and minerals (with sports drinks), wear appropriate clothing and sunscreen, pace yourself, stay cool indoors, schedule outdoor activities carefully, use a buddy system.

14.    How much should I drink during hot weather?
During hot weather, you need to drink more liquid than your thirst indicates.  Increase your fluid intake, regardless of your activity level.  During heavy exercise in a hot environment, drink 2-4 glasses (16-32 ounces) of cool fluids each hour.  AVOID alcohol drink, because they will cause you to lose more fluid.

15.    What about salt tablets?

DO NOT take salt tablets unless directed to do so by your doctor.  The easiest and safest way to replace the loss of salts and minerals is through your diet.  Drink fruit juice or a sports beverage when you exercise or work in the heat.

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A Cup of Joe, Stuff of life or Poison?

In this country, we drink 400 million cups of coffee per day.  We consume over 45% of the world’s coffee production.  For the record, some of the Scandinavian countries consume three times more coffee per person.

Given all this coffee drinking, it’s no surprise that this is one of the most researched beverages on the planet.  And yet there is almost universal confusion on the health consequences of coffee drinking.

The problem is, we started our coffee studies 40 years ago when we were just starting to suspect cigarettes were a bad thing.  The early coffee studies showed people dying of heart attacks, mouth, throat and lung cancer.   It turns out in those days, coffee drinking was accompanied by cigarette smoking, and the control group didn’t drink coffee or smoke.  So all the bad stuff that we thought was associated with coffee drinking, was actually associated with smoking, and had nothing to do with coffee.

In case you think studying coffee is a light weight task for the scientists that got “C”s; coffee has more that 1,000 different chemicals identified.  Apparently a few of them cause cancer in rats.  In fact, it’s pretty hard to pick 1,000 chemicals and not have a few of them be bad for somebody.

Coffee does some well-known bad stuff.  It can be associated with anxiety and sleep disturbance.  It modestly raises both blood pressure and pulse.  It increases the acid in your stomach, and it stains your teeth.  That is the crime list for coffee.

Ah, but the benefits.

Coffee, first and foremost, increases memory, performance and wakefulness.  That just might keep you awake at the next meeting, thus keeping your job, which is a major health benefit.  All this wakefulness results in a lower risk of Alzheimer’s disease.   Some gastrointestinal cancers occur less frequently in coffee drinkers; especially throat, liver and prostate cancers.  Parkinson’s Disease is less frequent among the well-caffeinated.  Type 2 diabetes also is reduced in coffee drinkers.  Caffeine is also known to potentiate pain medication (it makes it work better).

All in all, coffee is a lousy replacement for a good night’s sleep, and should be avoided by those with sensitive stomachs.  For the rest of us, a cup a Joe is a safe warm spot in a cold and stressful world; and that’s another health benefit.

– Dr Don Bucklin, National MRO – AKA “Dr B”

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It’s Lyme Time

Many of you may be venturing outdoors this summer for trips to a nearby lake or camping out in the wilderness. This means it’s time to take precautions in order to prevent serious infections, especially Lyme disease.

Lyme disease is an infection caused by bacteria and is spread by the bite of a deer tick. It’s important to understand that not all deer ticks are infected, so not all tick bites will cause the disease.

Ticks can be found almost anywhere outdoors, but they’re mostly in grassy and heavily wooded areas. The most common hosts for ticks are deer, humans, dogs, cats, cattle, horses and some mice. Deer ticks are very small—about 1/16th inch—and brown/black or rust/red in color. The endemic areas in the U.S. are the Northeast, the Mid-Atlantic, Wisconsin and Minnesota.

Here are some of the signs and symptoms that can start 2 days to several weeks after a bite:

  • A rash (occurs in about 50% of patients) – red, quickly enlarging and takes on a bull’s eye or ring-like form. It can be itchy or warm.

  • Flu-like symptoms – fever, chills, sore throat, conjunctivitis, fatigue, swollen glands, muscle aches, ear ache.
  • Without antibiotics, the disease can advance to involve more body areas, such as the heart, joints and nervous   system.

Lyme disease can be hard to diagnose at times. Not all patients develop a rash, and the symptoms can be vague or variable.

Despite this, the key thing to be aware of is prevention. Here are some tips to remember:

  • Wear light-colored clothing so that the tick can be more readily seen.
  • If practical, wear long pants/sleeves while in the woods, and tuck your pants into your socks for extra protection.
  • Use a repellant containing DEET (be careful with children).
  • Inspect your skin after possible exposure, especially hair-covered areas.

If you do find a tick, try removing it using tweezers and grasping the tick body (as close to the skin as possible) with a steady, upward motion until it comes out. Then wash the area with a skin disinfectant.

During this time of year, be sensitive to the risk of a deer tick bite. Protect yourself and enjoy the great outdoors!

-Donna Diziki, D.O., U.S. HealthWorks

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