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Doctor's Consultation  by Dr. Iain Corness

 

Taking the liver on holidays

After the usual heavy Xmas/New Year, many folk make their New Year’s resolution to lay off the booze for a period.
Now your liver is one of the most amazing organs you possess. Given the right circumstances, it can regenerate up to 90 percent of itself, a fact that many seasoned drinkers rely upon. Giving up alcohol in January is seen by many as an ideal way to begin a healthier new year. For those of you who have managed a “Dry January”, one that is free from alcohol, you might well be feeling a sense of achievement.
However, consultant hepatologist (liver specialist), Dr Mark Aldersley of Spire Leeds Hospital in the UK reports, “Giving up for one month is not enough to undo the long term damage caused by regular drinking. It's not a detox program or a quick fix. Year round action is what's needed. This involves having at least two alcohol free days a week, and ensuring moderate consumption on other days.”
Of course, none of this is easy. You only have to see the withdrawals when there is an election or religious holiday in Thailand, and hear the wails that the end of the world is about to happen!
Now for the bad news statistics. Alcohol related liver disease is the fifth biggest killer in the UK and is on the increase. Figures show that in the Leeds area on average 23 percent of people are drinking at a harmful level. “I'm particularly concerned about the increasing number of younger people that we are seeing,” says the consultant hepatologist. “We are noticing big changes with more people in their twenties and thirties dying from alcohol-related causes. Twenty years ago this was rare. People are starting to drink at a younger age and are drinking larger quantities.”
Dr Aldersley continues, “During the course of a month’s abstinence your liver will regenerate to a great degree but will not recover fully. People who have not badly damaged their liver stand a good chance of the liver regenerating and returning to normal function with abstinence for several months. If it’s badly damaged you can still gain some benefit from permanent abstinence.”
He calls liver disease the 'silent killer'. “Most people who have alcohol-related problems aren’t alcoholics. They probably would not be aware that their liver is damaged as there are no obvious outward signs in the early stages. People often think they are well even in the advanced stages.” He thinks the problem of over-indulgence is fuelled by the affordability of alcohol with people drinking larger quantities at home and quietly damaging their liver without knowing. Especially at risk are women and those who are obese as the liver is likely to already be damaged through them being overweight.
Another problem is caused by confusion over what a unit measures. “Often people don’t really understand the quantities or units in terms of government guidelines for drinking safely. Home poured glasses tend to be larger and are likely to be two or three units and pub measures of wine are larger than a few years ago,” he said.
“No one wants to make people's lives a misery by telling them to stop drinking and many people can enjoy drinking moderately. But people who have liver damage should abstain and others should try to limit intake to stay within the recommended number of units,” he said.
Dr Aldersley explained, “When the liver is damaged it starts to become inflamed, and then with further alcohol scarring develops. When it is severely scarred cirrhosis occurs. Cirrhosis will not heal completely; however, in the stages prior to cirrhosis, it’s often possible for the liver to heal completely,” he said.
Dr Aldersley recommends if people are concerned about the health of their liver they should ask for a liver blood test. (This is simple blood tests which shows the level of the liver enzymes.)
“It’s not just liver function that improves with abstinence. The benefits of giving up or cutting down alcohol consumption can include improved sleep, weight loss and saving money,” he added.
But remember that the definition of an alcoholic is: “Someone who drinks more than his doctor!”


Cheapest isn’t necessarily “best”

Had an interesting TV interview the other day. This was by a German TV channel which wanted to show that taking over the counter drugs was a dangerous practice, and had been to great pains to do some secret filming in Thai pharmacies.
The drug they wished to highlight was our old friend (or probably better described as the “friend of the old”), the blue diamonds. They had chosen Thailand because so many blue diamonds were being taken here, and they wanted to show the disastrous side effects from taking the fake pills.
During the course of the interview I pointed out that Germany has its own red light areas, so they could get the blue diamond statistics much closer to home, also we were not inundated with octogenarians with heart failure and loaded condoms, and “over the counter” drugs could be found all over the world, and not just here.
Guess what - they cut my interview out of the feature. Do not forget the journalist’s creed - “Never let the truth stand in the way of a good story”!
So back to counterfeit blue diamonds, how do you find out that yours are real or otherwise? Every day I receive Spam offering me the opportunity to keep a battalion of beauties satisfied. These are the internet email offers of cut-price drugs that will keep me in a state of perpetual priapism, a continuing (and painful) male erection and the term was coined after the Greek god Priapus who is shown in paintings to have a central member like a third leg.
Offers like these which are too good to be true, are usually just that - too good to be true! These cut-price drugs are not the real deal. The chances are very high that they are counterfeit.
One of the patients showed me a box purporting to be genuine brand name Cialis tablets, which were not having the desired effect. I was immediately suspicious as the box was not all that well printed. I was quite sure they were counterfeit when I read the Patient Information slip. The English grammar was incorrect, and there were spelling mistakes. Eli Lilly, the ‘real’ manufacturer does not send out misspelled literature with their product.
The World Health Organization puts the annual amount of counterfeit drugs sales at something like $35-40 billion per year. No wonder I (and you) get so many offers of drugs through the internet. That’s a very large pie.
The World Health Organization also estimates that one in three drugs on the worldwide market today is counterfeit. One in three! Sometimes the fake drugs contain toxic substances from which you can die.
Pfizer’s laboratories analyze fakes and a representative stated, “We’ve seen boric acid, we’ve seen heavy metals, we’ve seen road paint, we’ve also seen floor wax to coat the pills and give them a shine. Obviously, they are detrimental to anyone’s health.”
It is not just Eli Lilly that is targeted. Pharmaceutical giant Pfizer (yes chaps, the makers of the blue diamonds) estimates its annual losses to counterfeit drug sales at $2 billion.
However, this is actually a serious situation. If specific drugs are only available through pharmacies, on the prescription of a doctor, is it safe to just buy over the internet, without any doctor’s advice?
The American Food and Drug Administration (FDA) says, “Patients who buy prescription drugs from websites operating outside the law are at increased risk of suffering life-threatening adverse events, such as side effects from inappropriately prescribed medications, dangerous drug interactions, contaminated drugs, and impure or unknown ingredients found in unapproved drugs.”
According to WHO, drugs commonly counterfeited include antibiotics, antimalarials, hormones and steroids. Increasingly, anticancer and antiviral drugs are also faked. And you can add to that, the ‘blue diamonds’. Never forget the phrase “Caveat emptor” (Let the buyer beware).
If you receive a spam e-mail from someone who you don’t know, offering you specific pharmaceuticals at a cheap price, that should be enough for you to go no further. Get your medications on a doctor’s prescription from a pharmacy you can trust. Or suffer the consequences.
But now you can get the Government’s Pharmaceutical cheap equivalent of Viagra, called Sidegra - but get the ‘real’ one!


HEADLINES [click on headline to view story]

Taking the liver on holidays

Cheapest isn’t necessarily “best”