Feeding the nicotine habit with nicotine gum
DEAR DR. DONOHUE: I have a friend who hasn't smoked in a very long time. He stopped successfully when he finally began to use nicotine gum. He's still using it. What's going to happen to him because he has chewed this gum for so long? -- Anon.
ANSWER: On the bright side, your friend has lessened his chances of lung damage in the form of chronic obstructive pulmonary disease, and he has lessened his chances of lung cancer.
On the not-so-bright side, he's still feeding his craving for nicotine. Without a daily dose of nicotine, your friend's mood is less than happy. Nicotine causes a release of brain chemicals that ease his stress. It relaxes him. It also releases adrenaline, which puts the body on alert without a reason for being in the hyper-alert state. Nicotine constricts arteries -- a temporary effect, but one that does seem to have a role in artery hardening. It increases blood pressure for a short time. It does the same for the heart rate, an unnecessary heart burden.
Your friend must be strongly habituated to his nicotine habit, or he would see that the continuance of this drug, in any form, isn't good.
Nicotine withdrawal spawns irritability, anxiety, restlessness and depression. Those symptoms disappear rapidly. They shouldn't be used as an excuse to continue the habit.
He can follow the manufacturer's guide to weaning himself off oral nicotine. From day one and for the following six weeks, he chews a piece of gum every one to two hours. From week seven to nine, he chews a piece every two to four hours. From week 10 through week 12, chewing is limited to a stick every four to six hours. After that, the cease-chewing ordinance is in effect.
DEAR DR. DONOHUE: My wife, age 85, has been in a depression for the past 20 weeks. Neither of her antidepressant medicines has been helpful. She dresses and bathes herself, but not much else. She has no appetite. She can't taste food. She says food tastes and smells rancid. She has lost 25 pounds. Do you have a solution? -- R.G.
ANSWER: Loss of appetite is one of the consequences of depression. She hasn't obtained any improvement after taking medicines for four months. A different antidepressant should be tried at this point. She also would benefit from talk therapy with a mental health professional.
Even if your wife can eat only a few morsels of food, those morsels should be high-calorie ones. Yogurt with fruit has a decent calorie load. She might tolerate milkshakes. They have a good calorie load. Nutritional supplements like Ensure, found in all drugstores, are another way to provide her with needed calories.
In addition to losing her appetite, she has dysgeusia (dis-GOO-zee-uh), a distortion of taste. Sometimes that comes from reflux of stomach juices into the esophagus and mouth, a treatable condition. Ask her doctor if she would benefit from one of the many antireflux medicines.
DEAR DR. DONOHUE: What is the relationship between genetics and schizophrenia? -- Anon.
ANSWER: Genes have a hand in bringing about schizophrenia. It's unlikely that a single gene is responsible; it's more likely that an interplay of many genes is at work.
When one identical twin comes down with this illness, the other twin has a 50 percent chance of also developing it. Identical twins have identical genes. If genes were the only factor, both twins would exhibit signs of the illness.
The chances of someone from the population at large having schizophrenia are 1 in 100. If one parent suffers from schizophrenia, a child of that parent has a risk of developing it that is 10 times greater than someone from the at-large population. Genes do influence its occurrence, but are not the entire answer.
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Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.
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