Q: I used to take prednisone anytime I got poison ivy. Then my endocrinologist told me NEVER to take it for something so minor. My rashes were quite severe, but he said the prednisone could cause diabetes. That would be much worse and last much longer.
My husband had a total knee replacement. After several months, he was still having some pain. Against my wishes, he and the doctor thought a steroid shot would do the trick. The resulting severe case of shingles was no joke. It was much more painful for him than the surgery.
Steroids are dispensed too frequently. They are miraculous but also very dangerous. Everyone should be aware that diabetes and shingles are possible side effects.
A: We agree with your endocrinologist that corticosteroids like prednisone can increase the risk for diabetes when taken for long periods of time. Such drugs also dampen the immune system. This can lead to a resurgence of the virus (herpes zoster) that causes shingles (Open Forum Infectious Diseases, Sept. 28, 2016).
A bad case of poison ivy is not always a minor problem, though. There are times when a short course of prednisone is justified.
Q: I took omeprazole for years, but when I learned it could weaken my bones my doctor switched me to ranitidine (Zantac). I was pleased to be using something safer for my reflux, but then I read that ranitidine may contain a cancer-causing chemical.
What else could I take to ease heartburn symptoms? I do not want to return to a PPI.
A: Have you considered famotidine (Pepcid)? It is in the same class as ranitidine, but its different chemical makeup means it has not been linked to potential carcinogens. Like ranitidine, it is available without a prescription.
You can learn much more about preventing and treating acid reflux and other gastrointestinal conditions in our newly revised eGuide to Overcoming Digestive Disorders. It is available in the Health eGuides section of www.PeoplesPharmacy.com.
Q: Forty years ago, my doctor told me to use Vaseline petroleum jelly in my nose. It keeps my nose comfortable and prevents nosebleeds.
I tried Ayr Nasal Gel but found it less effective, so I went back to the Vaseline. You just put a small amount on a cotton swab and coat the inside of your nose. It doesn’t take much.
A: Many people use Vaseline or other petrolatum products to moisturize their nostrils, just as you do. One reader commented: “I have used Vaseline many times as a remedy for dry sinuses. Vicks VapoRub is good as a substitute. I have never had any adverse effects from the use of petroleum-based products.”
We recommend against using petroleum jelly in the nostrils. The trouble is that when you breathe in tiny particles of the petroleum product, they enter the lungs and can cause a pneumonialike reaction. Such lipoid pneumonia is considered rare, but it can cause significant shortness of breath (Chest, March 1994).
A case report of a young woman who used Vicks VapoRub around, not in, her nostrils for a year demonstrates that the consequences can be serious (Respiratory Medicine Case Reports, July 8, 2017). She had cough, fever and shortness of breath. Her abnormal chest X-ray led to a CT scan of the chest that demonstrated widespread pockets of lung inflammation.