The People's Pharmacy

Joe Graedon, M.S.,and Teresa Graedon, Ph.D.

Q. I had silicone breast implants for 23 years before the left side ruptured and spilled 100 grams of silicone into my body. I was not told that they would ever need to be replaced.

I had many symptoms. My body hurt to sit in the car. I had so little energy.

I felt better after explant and reimplantation with saline seven years ago, but the symptoms are returning, and both breasts are painful. I now read that even saline implants can be problematic because the shell is made of silicone.

A. The Food and Drug Administration has a name for your condition: “breast implant illness” or BII. The agency notes that some patients blame their implants for symptoms such as “fatigue, ‘brain fog,’ muscle or joint pain and rash” (FDA’s Final Guidance for Labeling Recommendations for Breast Implants, Sept. 28, 2020). In the future, the FDA recommends that companies and surgeons inform women about BII and other implant complications. Unfortunately, it took the agency more than 50 years to issue such warnings.

Q. Should you take your blood pressure medicine in the morning or at bedtime?

A. A large study conducted in Spain including more than 19,000 people with high blood pressure found that bedtime dosing works better (European Heart Journal, Oct. 22, 2019). People who took their medicine at bedtime had better overnight blood pressure control without interfering with daytime hypertension management.

An analysis of 153 studies carried out over 45 years confirmed these results (Advanced Drug Delivery Reviews, Jan. 22, 2021). The researchers reported that when hypertension medications were taken at bedtime/evening rather than upon-waking/morning, there were fewer adverse drug reactions and better kidney function.

To learn more about blood pressure monitoring and control options, you may find our eGuide to Blood Pressure Treatment helpful. This electronic resource can be found in the Health eGuides section at www.PeoplesPharmacy.com.

Q. I have suffered with psoriasis for more than 45 years and have taken almost every treatment dermatologists offer. All are temporary and dependent on constant treatment.

I am currently on Otezla, which is extremely effective. However, I find that sun, saltwater and glycerin-based creams are the only ways to gain relief without prescriptions. Another calming topical is emu oil.

A. Otezla (apremilast) is a pricey prescription pill used to treat psoriatic arthritis, psoriasis and a rare inflammatory condition called Behcet’s disease. If your insurance company doesn’t cover it, the cost could be daunting. You may have to order it through a specialty pharmacy rather than through your neighborhood drugstore. When we inquired, we were told the price without insurance could be over $4,000 for a month’s supply.

Side effects may include headache and digestive upset (diarrhea, indigestion, nausea and vomiting). Clinical trials show that it is more effective than placebo, but it won’t work for everyone.

Thanks for sharing your nondrug approaches. Other readers agree that these inexpensive options can be helpful.

(In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of King Features, 628 Virginia Drive, Orlando, Fla. 32803, or email them via their website: www.PeoplesPharmacy.com.)

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