DEAR DR. ROACH: My daughter smokes. She doesn't have COPD now, but last spring she had bronchitis and was off work for a week.
When she went back to work, she didn't feel good, and her doctor told her that she had pneumonia in both lungs and wondered why she went back to work. She still takes cough syrup under her doctor's orders. — N.P.
ANSWER: Getting someone to quit smoking is a challenge, but perhaps some advice I can give your daughter might help. The first piece of advice is that a cough necessitating cough syrup on a routine basis indeed might be a sign of COPD. There are two major forms of COPD: emphysema and chronic bronchitis. The definition of "chronic bronchitis" is a productive cough for three months in each of two successive years.
The second piece of advice is that quitting before there are serious symptoms is the best time to quit. Although the body has some ability to recover from the effects of chronic cigarette smoke, there is a degree of permanent damage in long-term smokers. Quitting greatly slows down the rate of ongoing damage to the lungs and reduces the risk of having lifelong symptoms of shortness of breath and cough.
Quitting smoking will do more good than any cough syrup can.
DEAR DR. ROACH: Does taking Norvasc or any calcium channel blocker reduce or destroy the calcium in the bones, eventually causing osteoporosis? — E.G.
ANSWER: No. Calcium channel blockers, like amlodipine (Norvasc), work on cells in the heart and blood vessels, controlling the flow of calcium into the cell. Calcium in the cell is one of the regulators of smooth muscle cells, and for Norvasc in particular, that means its major effect is on blood vessels, causing them to open up and reduce blood pressure, and thus the amount of work the heart needs to do.
Calcium in bone is used structurally, where it combines with other ions to form hydroxyapatite, the mineral that keeps bones hard and strong. The mechanism for calcium entry into bone cells is very different. Calcium channel blockers do not affect mineralization of the bone, nor do they increase the risk for osteoporosis.
One group found that people on calcium channel blockers may have a slightly higher risk of fractures; however, that was thought to be due to an increased number of falls, especially in the elderly. Physicians need to take care not to use too much medication, especially ones that dilate blood vessels, as they can increase risk of dizziness and falls.
DR. ROACH WRITES: Many readers kindly shared their recommendations about preventing underarm odor, and the most commonly mentioned, by far, was crystal mineral salt deodorants, of which there are several brands. Several people made their own deodorants by mixing baking powder, cornstarch and olive or coconut oil. Other people noted using antibacterial soaps or cleansing products containing the same products we use in the operating room, such as chlorhexidine and hexachlorophene. A product with zinc oxide and talc helped one reader. Finally, more than a few people noted that removing all underarm hair was necessary to successfully get rid of odor.