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DEAR DR. ROACH: My question is about medical bracelets and necklaces. I’ve never seen any recommendations as to what conditions would warrant wearing one nor what the inscription should say. When are they either necessary or beneficial? – D.A.M.
ANSWER: Medical ID tags can be useful. They serve to alert medical personnel of potentially important medical conditions when someone is not capable of providing that information, whether due to temporary incapacity (such as being unconscious in a motor vehicle accident) or permanent disability (such as intellectual disability). In my opinion, the most appropriate use of these tags is when there is a potentially life-threatening medical condition that would not be obvious to emergency medical personnel.
Some examples of these would include anaphylactic reaction to medications or latex; the presence of an illness that can cause temporary disability (epilepsy, diabetes, Addison’s disease); and medical conditions that might affect use of some common treatments, such as bleeding disorders, organ transplant status and medical implants (such as implantable defibrillators). Personal and contact information is a natural set of complementary information to have on a medical tag.
Some newer tags include electronic information, but this is in its infancy. These include the use of near-field technology to let emergency personnel read the information (if they also have the technology); phone numbers the emergency personnel can call to get more information; and QR codes to allow emergency personnel with a smartphone to go to a webpage with more detailed information. Most smartphones also have the ability to store information that can be read in an emergency, even by someone without the person’s phone password. I recommend taking advantage of this feature.
Many of the ID tags I see have information that is not likely to be helpful. Listing chronic conditions like high blood pressure or high cholesterol is not necessary.
Finally, one of the biggest benefits of a medical ID tag is a little peace of mind.
DEAR DR. ROACH: Regarding a recent column: If a body does not need help in maintaining pH balance, why does the consumption of different foods cause changes in urine pH? – K.F.
ANSWER: The body has two main organs with which to regulate pH, the acid/base status of the body based on food intake, exercise, medications and other causes that would perturb the body’s pH, which is very tightly regulated and slightly alkaline at about 7.4.
The more important and faster-acting is the lung. By increasing the respiratory rate, we excrete more carbon dioxide, which is in equilibrium with carbonic acid. Breathing more deeply and quickly can move the blood pH toward the alkaline side. This usually happens without our being aware of it.
The kidneys are the other important organ for long-term regulation of pH. The kidneys can regulate reabsorption of carbonic acid in the tubule, increasing or reducing acid secretion. So, urine that is more acidic than normal may mean the body is ridding itself of excess dietary acid and thus making blood pH more alkaline. Ammonia is another way the kidney can regulate pH balance.
Blood pH does not vary more than a minute amount from its expected level except in cases of critical illness, disturbances in kidney function or diseases that affect control of breathing.
Dr. Roach regrets he is unable to answer individual letters, but he will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu.
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