Is it OK to crush pills?

#Middlebury #Health

DEAR DR. ROACH: I would like to know your opinion about whether it is OK to crush up different psychiatric medications and put them in a small container of water to drink. This doesn’t seem very safe to me, but I’d like an expert opinion. – Anon.

ANSWER: I’ll give you my answer, and also tell you where to find an expert opinion. My answer is that many people have trouble swallowing pills, and that most pills can be crushed and taken with water or mixed in with food. Your local pharmacy sells pill crushers, or you can get a mortar and pestle.

While you are at the pharmacy, ask your pharmacist. He or she can look at your medications and tell you whether it is safe for you to crush your particular medications. Slow-release medications, of which there are many, should not be crushed. Often, the bottle will tell you, but ask your pharmacist for the expert opinion.

DEAR DR. ROACH: What are your thoughts about the MiraDRY procedure to get rid of underarm sweat? Is it safe not to have sweat under the arms? – S.J.

ANSWER: MiraDRY is the brand name of a microwave device designed to treat hyperhidrosis (excessive sweating). This is not normal underarm sweating, but a rare condition of abnormal, drenching sweat that greatly interferes with social activities. It is currently used only for underarms – not hands, feet or face, the other most common places for localized hyperhidrosis.

According to several published papers, the microwaves heat up the water in the sweat glands, destroying them, while the skin itself is cooled. The published success rates (at reducing sweating to “never noticeable” or “tolerable”) are very high, as are patient satisfaction results. Side effects included swelling, redness and temporary numbness.

This is a new procedure, but it appears to have promise in the treatment of excess sweating. I also found a very helpful website at www.sweathelp.org.

DEAR DR. ROACH: What causes foot drop? Is there any cure for it? – B.H.

ANSWER: Foot drop is most commonly caused by damage to the peroneal nerve, which wraps around the fibula, one of the two bones of the leg (anatomically, only the lower leg is called the leg, as opposed to the thigh). The nerve can be damaged from trauma, such as during surgery or prolonged hospitalization. Leg casts and prolonged positioning with stress on the nerve, such as squatting, also can damage the nerve. Most people describe numbness but not pain, and the dropped foot can cause people to trip, so people with this condition learn to flex the hip to lift the thigh up higher. The diagnosis can be confirmed by electrical studies of the nerves.

Treatment usually is to prevent further damage, with a splint to keep the foot flexed upward. A physical therapist can prescribe helpful exercises.

Dr. Roach regrets he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu. To view and order health pamphlets, visit www.rbmamall.com, or write to Good Health, 628 Virginia Drive, Orlando, FL 32803.

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