Dr. Michael Roisen
Q: Q: I gained about 25 pounds during the pandemic, which is affecting my health, but when I went to the doctor for an annual health check (eventually) she was to lose weight I didn’t do it because I didn’t say a word about what to do. Need to make another promise and insist on discussing it? — Janna R., Portland, Oregon
A: A: This is a great and very complicated question. Advocates of people with eating disorders believe that most health conditions can be addressed without having to focus on weight or weigh the patient at each visit to the doctor. “Don’t weigh me unless (really) medically necessary. If you really need my weight, please tell me why you can provide informed consent,” said Los Angeles-based eating. Created by coaches with disabilities, it is welcomed by some doctors as a way to actually initiate tough conversations more effectively. On the other hand, some doctors find it difficult to talk about weight and avoid the topic altogether. Yet others believe that weight, such as blood pressure and LDL cholesterol levels, are data points that must be included in all assessments of a person’s health.
Researchers at the University at Buffalo recently published a treatise suggesting a compromise. They say that obesity and weight should be dealt with in a health-focused way that eliminates weight stigma and prevailing dietary culture. It is also the outlook for another new study of journal obesity. Researchers have heard from obese patients who have lost more than 50 pounds and lost weight. They said that being motivated by health concerns was effective and helped them feel at ease mentally and physically.
Conclusion: It is wise to make an appointment with another doctor to talk about improving nutrition, making better food choices, controlling doses, and improving health by changing the timing of meals. We would also like to discuss ways to improve stress management and increase physical activity. A wide range of regimens developed by the two will improve your well-being — and you will lose weight.
Q: Q: I take Xanax several nights a week to relieve anxiety and help my sleep. Within 2 months, I have undergone total knee osteoarthritis. Doctors say they prescribe opioids for postoperative pain management. That combo worries me. Should I try to pull myself away from sedatives before surgery? What do you think? — David Y., Erie, Pennsylvania
A: A: Your instinct is right. Combinations of benzodiazepines and opioids such as barium and Xanax are potentially deadly. According to the Food and Drug Administration’s Pharmacovigilance Communication, the main risk is that the duo suppresses the central nervous system, making breathing slow or difficult.
Nonetheless, according to a new study of community anesthesia and pain medicine, 2.6 million Americans are prescribed opioids and benzodiazepines or other sedatives at the same time. And it’s not just occasionally. Researchers have found that the average annual number of prescriptions these people have filled for opioids, benzodiazepines and other types of sedatives is approximately 25 per person.
There are some interesting studies showing that naproxen and acetaminophen are also effective for severe postoperative pain, both of which can reduce or eliminate the need for opioids. Talk to your doctor about whether that approach works for you.
How about staying at Xanax until, during and after surgery? Studies have shown that these types of medications can interfere with the outcome of knee surgery and increase the rate of correction, resection, fixation of femoral fractures, and even delirium.
So talk to your surgeon about this. If that’s what you decide to do, ask for help in quitting Xanax and explore pain management options as an alternative to opioids. If you need more information, you can find safe pain management information at facs.org at the American College of Surgeons.
