Dr. Dave Hnida's Blog

A heads-up from the FDA about high doses of Zocor, a statin drug we use to help lower cholestererol. The agency says people taking the 80mg pill need to know they may be at an increased risk of muscle and kidney damage.

So here's what you need to know- Zocor is the name brand, but the generic version is simvastatin- and the generic version is what most people take. Zocor is also found in another cholesterol lowering drug- Vytorin- although its unsual to give people the pill with 80mg of simvastatin in it.

The problem is the high dose may do a number on muscle fibers in the body- meaning it actually cuases the muscles to break down... and when it breaks down, chemicals from the muscles head to the kidneys for filtering. But- the kidneys often cant handle those chemicals and the result is kidney damage.

Here's the messages. First, if youre on simvastatin, be aware of muscle soreness or muscle pain. For that matter, if youre on ANY statin, you need to pay attention to muscle soreness or muscle pain. Thats because any statin drug can have muscle damage as a side effect- its just less common with the lower doses of other statins (but once again, can happen with any statin, at any dose.)

Finally, if youre on that 80mg, talk to your doctor and see if there's anything you need to be doing differently above and beyond knowing the risk of the high dose.

Two kids are better than one, or none... or maybe 3 or 4. Thats according to new research involving  more than 3 million people which looks at life expectancy and the number of kids you have.

Its seems the optimal number is two, at least according to this study.

Have no kids, or just one kid, and your motivation to stay healthy is not as high as someone with children. At least thats the explanation for why childless or child-few people tend to suffer more chronic diseases and die younger.

Go to three or more kids, and death rates went up again- the explanation here is that the more kids you have, the more stressed you are and the weaker your immune system.

Supposedly two is best.

I dont know what to tell you about this study- Ive got four kids and they havent driven me to an early grave, at least not yet. But in the study, there were no time limits on how long your kids were allowed to pester you before you finally dropped dead.

As if having erectile dysfunction isnt bad enough, here's more bad news. It appears that if you have underlying heart problems and E.D. , well, thats a sign things are so clogged up, your risk of heart attack and death are doubled.

The research comes from the journal Circulation, and thats precisely the point: circulation, If youre not getting enough blood to your genitals to allow an erection, your blood vessels are clogged up. And if they are clogged up in your genitals, your heart arteries are probably clogged up more than you realize.

Now this has little to do with psychological impotence- here is a message--- If you have a history of heart disease, or for that matter,  risk factors for heart disease, your doctor shouldnt just be whipping out a prescription for Viagra or Cialis is the equipment isnt working well down below. You may have a bigger problem in your heart... and that problem can kill you.

 in fact, even if you dont have risk factors, if things arent working the way they should, talk to your doctor and see what sort of exam and tests you need to confirm your heart is in good shape. Think of an erection, or really, lack of an erection, as an early warning signal that should not be ignored.

A nice big study out today about the birth control pill. For years, we've worried that it might be harmful to health over the long term... but the opposite may be true.

A study from England followed more than 46,000 women for more than 40 years and finds that those women who took the pill tend to live longer than those who did not. The study began way back in 1968 when we were prescribing the "Model-T" version of the pill- ones with high doses of hormones.

The average length of time the women used the pill: four years. The effects- a lower rate of cancer and heart disease. The most striking effect was a 38% lower risk of colon cancer.

Why might the pill help you live longer? Lots of guesses but no firm answers. But there is one larger question: this study looked at pills from decades ago- how about protection from the today's pills, which contain much lower doses of hormones. Once again, no firm answer. In fact, it may be 40 years before we know- thats how studies work.

But one thing is for sure, old pill or new. Smoking and the pill is a deadly mix- higher rates of heart attack, stroke, and blood clots.

If you are, you may want to think about what the habit is doing to your face.

According to a group of dermatologists and plastic surgeons, chewing away on a regular basis overworks the muscles around the mouth and weakens the underlying supportive tissue. The result: fine lines, wrinkles, and just plain looking older.

But not all doctors believe the theory, What about smiling? Or talking? Then there are the positives such as gum freshens breath and fights cavities.

So I dont know whether you should kick the gum habit to keep from getting crinkly-face. Believe either set of experts.

But there are some things you can do if you are going to stick with chomping on a slice- dont chew with your mouth open, and please, please, please, dont crack your gum. Theres a well known link to high blood pressure.... in people who have to listen and look at your gum smacking performance.

I learned something today, and frankly I'm a little embarrassed I didnt know better. Perhaps naiive is the best term. Here's what its all about.

For years one credo in medicine has been "Once a C-section, always a C-section." The thinking was once a woman has a C-section, she should just forget about trying to deliver vaginally since there was a risk of complications, such as an intense labor rupturing a c-section scar.

But it turned out that the risk is much less than we thought, so more and more women were asked: "Do you want to try a vaginal delivery? We can always do a C- section if things start to go wrong." So more women went the vaginal route with subsequent research showing the risk of "go wrong" is pretty low.

So here's the punchline. The National Institutes of Health just officially recommended that women be offered a trial of a vaginal delivey after a C-section. I was confused. I thought we'd already had some official recommendations on this. For years.

It turns out some hospitals and organizations took that original set of recommendations and turned them around: making an official policy of NO CHOICE. Meaning, once a C-section, always a C-section is the way its going to be, like it or not. In fact, its estimated 30% of women who have a C-section wind up being told- tough, this is the way it is, like it or leave it.

Well, I say leave it. Sure, maybe a vaginal delivery after a C-section isnt for you, and maybe you dont even want to consider it. But you should at least be offered it as a choice to consider. I mean, we're not living in the 1800's here. But if the NIH has to make a big announcement and stomp their feet saying  "Hey, give women a choice." maybe we are farther back in medical time than I thought.

Right now, only 20% of women who have a C-section later give vaginal delivery a shot. I hope most of them have made that choice, not told they had no choice.

The President went in for his annual checkup this past weekend, and the White House released the results of his labs and testing - we'll talk about his nicotine addiction in a second.

So here's how he stacks up- why dont you compare your numbers to his:

Height 6-1 Weight 180 which equals a BMI of 23.5- not too thin, not too chubby- just right

Heart rate 56 - for most people its 72 beats per minute. A slow heart rate usually signifies excellent physical conditioning.  Bottom line- he's in good shape.

Blood pressure- 105/62.   We like to see it 120/80 or lower. So his numbers are excellent. If I was President I'd be running 240/125.

Total Cholesterol 209- oh boy, too high. This number should be 180 or  lower. But, for a true picture you need to break the numbers down. His HDL or good cholesterol is 62- thats really, really good. In fact you usually dont see a good cholesterol that high in a male.

On the other hand, his LDL or bad cholesterol is 138- like to see this one under 130. So I read he walked a few hundred yards today to the White House instead of catching a limo ride. That'll help, but not as much as ditching the smokes. It seems the President still is addicted to puffing a cigarette every once in a while. A few per day is better then Eisenhower, who smoked four packs a day- but just saying no to tobacco would lower the cholesterol in a matter of weeks, to say nothing of the other positive health effects. In the meantime, he'll keep on chomping away on a few pieces of Nicorette to crave his urgings. (makes me wonder how much Jeff Kuhl, his personal physician, yelled at him.)

Other than that, he'll need some reading glasses soon; he had a virtual colonoscopy which was normal, and he's got a little tendonitis around the kneecap, which a little stretching and ibuprofen should help.

All in all a clean bill of health. But it does show even nicotine is stronger than the most powerful man on Earth.

Okay, put on a happy face (even if your insides are ready to explode.) A new study says just "making believe" youre happy is heart healthy and will lower your risk of dropping dead.

So let's see. Your girlfriend dumped you for another guy. Your dog ran away. And someone stole your pickup truck. (Sounds like a country music song, doesnt it?) But if you could somehow, someway, just put a grin on your face, your body will be fooled into thinking life is great.

The research comes from the American Heart Association and finds people who are truly happy produce less harmful chemicals that can clog heart arteries and raise blood pressure. Even better, people who were miserable but faked it also produced less of those harmful chemicals.

So gray skies are going to clear up, put on a happy face. (Even if you dont mean it and its raining like the dickens)

According to the National Institutes of Health, you shouldnt automatically bail on milk, ice cream, cheese, etc if you suffer from lactose intolerance. Easy for these folks to say- they probably werent gassy, nauseous, or bloated when they wrote the report.

But here's the gist: research shows small amounts of lactose containing products can usually be eaten or consumed by lactose intolerant people- the key is small amounts. But it gets better. The more lactose you take in, the more your body is able to handle. In other words, start with very small amounts and let your body build up a tolerance.

This is obviously very important for growing kids, who need calcium; for women, who also need calcium; and for all of us-who could use the Vitamin D often found in dairy products.

A little background- people who are lactose intolerant generally dont have enough lactase in their digestive tracts, so when they consume lactose (or milk sugar) , they cant digest it and their intestines start doing some funky dance moves. But even people with full blown lactose intolerance have at least a little lactase, and will make more when they slowly and gradually are exposed to more.

So think about starting out slow... and see what happens.

Heres a nice article on lactose intolerance: http://my.clevelandclinic.org/disorders/lactose_intolerence/hic_lactose_intolerance.aspx

A big dilemma in pregnancy is the use of antidepressants- the medications are obviously a huge benefit for women who suffer clinical depression. But the question always seem to hang out there: just how safe are these medications for the developing baby? most studies say the benefits far outweigh the risks, a few studies have raised some red flags. Its a tough decision.

There may be an alternative, a little natural medicine. A new study in the Journal Obstetrics and Gynecology finds acupuncture may be very helpful in easing the pain of depression, without the potential side effects of medication.

The study was done at Stanford University and found acupuncture eased the symptoms of depression in 63% of pregnant women who were treated with a regimen specifically designed for depression. Thats a good number. And while one study does not make for a broad recommendation, its a study that says pregnant women and their doctors need to at least consider the treatment if depression and pregnancy are going on.