The seven poor health habits

Physical inactivity[1]
Scientific literatures have reported the beneficial effects of regular physical exercises on health. Aside from strengthening muscles and bones, they protect the heart from the so-called myocardial infarction (heart attack) because through physical exercises, the small blood vessels supplying the heart with blood are assured of being open most of the time, in addition to the development and opening of others, medically known as the collateral coronary arteries.
Again, scientific literatures are laden with findings that cigarette smoking is bad for your health. Aside from definitely causing cancer of the lungs, they induce the blood vessels to become inelastic and non-extensiblecontributing to, and causing, the development of hypertension. Based on most health statistics of different countries, hypertension as a cause of death ranks as one of the top ten.
Drinking too much alcohol[1]
Too much intake of alcohol will lead to the development of the so-called liver cirrhosis. In this disease, formation of fibers and scarring take place in your liver, making it ineffective to do itsvarious functions for your body, such as eliminating some waste products and forming new and useful substances. Damage of the liver is so critical because when it fails, other organs will subsequently fail.
Being overweight[1]
If your weight is more than your so-called ideal body weight, you will soon develop hypertension; and since hypertension has a lot of complications, you will soon have more medical problems than you have thought and imagined. Aside from diseases in the heart and blood vessels, if you are overweight, you will also have problems pertaining to your knees and other joints, aside from the fact that you will be prone to having bone fractures.
Eating between meals[1]
If you take light snacks in between meals, then that is okay and tolerable. However, if you take a lot of foods prior to, and after, your regular meals, then that spells a lot of difference because intake of large amount of foods could cause sudden rise of your sugar, cholesterol, or triglycerides in your blood depending on what type of foods you took in. Scientific literatures suggest that taking in small quantities of foods—even if more frequently than usual—is more healthy thantaking big amounts of foods even if taken at a lesser frequency.
Skipping breakfast[1]
When you take your dinner at 7:00 o’clock in the evening and take your breakfast the following day at 7:00 o’clock in the morning, the time difference in between the two meals is 12 hours. If you take your lunch at 12:00 noon, the time difference is only 5 hours. And if you take your dinner again at 7:00 o’clock in the evening, the time difference is only 7 hours.Among your regular meals, breakfast has the longest time difference from the previous meal. Thus, it is called breakfast because when you take it, you are actually breaking your fasting! This is the reason why breakfast is so important because you need to replenish a lot of substances consumed by your body in the last 12 hours.
Sleeping too little or too much[1]
Most scientific references recommend that you sleep at least 7 hours every night. If you sleep less than 7 hours, you feel drowsy and your concentration in doing your work is below the optimal level. If you sleep more than 7 hours, you will feel lousy and you are not efficient in doing your work. What is more alarming is that when you lack sleep for several days, your heart will suffer. You will have irregularity in the beating of your heart.It will lose its normal rhythm until you get the right number of hours of sleep!
1. Glover, Bob, Shepherd, Jack, and Glover, Shelly-lynn Florence. The Runner’s Handbook. New York: Penguin Books USA Inc., 1996.

What are the components of your annual medical examination? (Part 7)

Other examinations
Stool examination
Stool examination refers to the laboratory analysis of the material that you move out when you do your bowel movement. The examination is done in two ways: (1) grossly, or (2) microscopically. In gross examination, the stool is observed and analyzed without using any instrument. In the microscopic examination, the analysis is done with the aid of the microscope.The results of the examination—be it grossly or microscopically—would give you an idea of the medical condition of your gastrointestinal tract, andthe following are significant findings if the laboratory technician and examiner could see them in your stool:
Eggs of parasites
If the stool examination would report that there are eggs of worms, then you are infected with them. The most common eggs that are seen in the stool come from the roundworms, specifically the parasite with scientific name Ascarislumbricoides. Roundworm infestation is very common among children who reside in the slums, eating without observing proper sanitation in their foods and dining wares. However, they couldalsobe seen among adults. If your stool examination would reveal the presence of eggs of parasites, then you must consult a medical doctor because you need to take medication(s).
The presence of blood in your stool could also mean a lot of things. The first that should come to your mind is the presence of any ulceration in your gastrointestinal tract. If the blood can be seen grossly, then the ulceration could be big and quite serious. If seen microscopically, then it is small.
Blood in the stool could also mean a bleeding cancer. Therefore, the moment your stool examination reveals the presence of blood, you need to bear that in mind, and, yearly, you need to have stool examination to find out if the bleeding is worsening or not. If worsening, you need to see your medical doctor because it is possible that you have been having cancer in the gastrointestinal tract—be it in the stomach or in the intestine.

Fats and undigested materials
If fats are present in your stool, then it is possible that you are not capable of digesting them. You have what is medically known as fat intolerance , and you may need to take some enzymes to help you digest your fats. In addition, some undigested materials could be seen in your stool. This again will indicate that you cannot digest some groups of foods; therefore, you need to see your medical doctor for further test(s) and/or for your medication(s).
White blood cells
Normally, the white blood cells are not found in your stool. However, if they are present, it means that you have ongoing infection in your gastrointestinal tract. Again, you need to see your medical doctor without delay so that you could take the right medication(s), preventing the worsening and spread of the infection.
Some words of caution: it does not mean, however, that if your stool examination does not reportpresence of white blood cells, that you do not have infection in your gastrointestinal tract! If there are other indications that an infection is present in your gastrointestinal tract, your medical doctor will proceed to treat it as a form of infection, even if white blood cells are not present in your stool.
Parting words on “annual medical examination (AME)”
The importance of AME cannot be underestimated. It is needed to serve as basis of preventive measures. Without it, your medical doctor is not properly guided on what preventive measures he could implement for you. Do it without delay!
(Last of a series of 7)

What are the components of your annual medical examination? (Part 6)

Other examinations


Endoscopy is a medical procedure wherein an instrument—called an endoscope–is inserted in your anal opening, and its end is pushed upward in the hollow space of your intestines. For your additional information, your intestines are divided into: (1) the small intestines, and (2) the large intestines. Your large intestines, in turn, are divided into the following (Refer to Figure 1 below): (1) ascending colon, (2) the transverse colon, (3) the descending colon, and the (4) rectum. When endoscopy is done, the most that it can reach are the parts of the large intestines. Therefore, it is very feasible in looking at the medical condition of the rectum, descending colon, transverse colon, and the ascending colon. This procedure is resorted to when you experience difficulty in moving your bowel, when your abdomen is gradually enlarging and you are losing weight, and when you noticesignificant amount of bloodbeing admixed in your stools!


Ultrasonographyutilizes sound to derive a picture of internal organs and structures. For instance, if the result of your urinalysis reveals that there are plenty of red blood cells, then ultrasonography may be resorted to find out the cause of your bleeding in the urinary tract. There are two possible causes of bleeding in your urinary tract: (1) you have stone which has been injuring the lining of your urinary tract, or (2) you have bleeding cancer in your kidney or urinary bladder. If ultrasonography is done, then—by and large—the exact cause of the bleeding can be determined.Ultrasonography can also be used to determine medical problem(s) in the liver or gastrointestinal tract.

Other tests

Alpha- fetoprotein

If ever you had ultrasonographyof the liver and if there was a new growth in it, the determination of the alpha-fetoprotein will be resorted to. If this substance in the blood is very much higher than the normal values, then it is possible that you have been suffering from cancer of the liver medically known as hepatocellular carcinoma. If you are suffering from this liver disease, aside from the positive results from ultrasonography and blood test for alpha-fetoprotein, your medical doctor may find out during the physical examination that your liver is enlarged and your eyes are colored greenish. With all of these findings, very likely, you have hepatocellular carcinoma. To definitely confirm that you have it, your medical doctor may request for biopsy of your liver, wherein a needle is pushed into your liver and sample tissue will be taken from it. The sample tissue will then be examined under the microscope, and it will be known in due time whether or not you have hepatocellular carcinoma.

Prostate-specific antigen

The prostate-specific antigen (PSA) is a blood test which is required from men 50 years old and over. It is an indicator of whether or not you have been harboring prostate cancer. Thus, if the level of your PSA is higher than the normal ranges, you need to have the test more often—yearly, at the very least—and you need to have aurologist (medical doctor for this kind of problem) who will follow you up. Ideally, before you submit yourself for this test, a urologist has seen you and has examined your prostateby doing the digital rectal examination, wherein he inserted his finger into your anal opening and was able to touch your prostate, feeling its consistency and its size. If your medical doctor appreciated hard prostate and your PSAvalue is high, then most probably you have prostate cancer.

(To be continued)

What are the components of your annual medical examination? (Part 5)

Laboratory examinations

Blood chemistry analysis

Alanine aminotransferase

Alanine aminotransferase (ALT)is one of the enzymesthat is measured and monitored to find out if you have medical problem(s) in your liver. This enzyme is highly specific for the liver; therefore, if it is elevated, or higher than the normal values, you really have a disorder in your liver. It was formerly known as the serum glutamic-pyruvic transaminase (SGPT).

Blood urea nitrogen and creatinine

Theblood urea nitrogen (BUN) and creatinineare the indices for evaluating the medical condition of the kidneys. If the blood levels ofBUN and creatinine are over the normal values, then it is possible that you are beginning to have problem in your kidneys, or you have been having problem with your kidneys for a long time, if the levels are considerably high. There are two most common causes of kidney problems. These are: (1) diabetes mellitus (DM), and (2) hypertension. Thus, if you have been suffering from DM, even if you have been taking the right medications, you still need to have periodic measurement of both your blood BUN and creatinine.If you have hypertension, take the necessary medication(s), without waiting for the rise in your blood BUN and creatinine.

Chest x-ray

X-ray of the chest is very important part of the annual medical examination (AME), especially if it is your first time to undergo AME. If the results of your first chestx-rayare normal, and if you are over 50 years old, then you can afford to have it every 5 years. However, if there are positive findings that need to be followed up—to find out if it(they) is(are) worsening or not—then you need to have it every year or every two years depending on the nature of the medical finding(s) and on the advice of your medical doctor.

The most important findings that you need to pay attention to in the chest x-ray are the following: (1) any new growth which could be cancerous in nature, (2) any infectious disease, such as tuberculosis or pneumonia, and (3) any abnormality of the heart, such as enlargement. If new growth is found, then further tests need to be done, such as getting a sample of it then examined under the microscope.


The electrocardiogram(ECG) is a tracing on a paper which is produced by the instrument called electrocardiograph. By interpreting the tracings on the paper, the reader could say if you have heart enlargement, if certain part(s) of your heart is(are) not well supplied with blood (myocardial ischemia), if you have problem with the electrical current of your heart, if your heart rate is slow or fast, and if your heart rate is irregular—among other things. Among the medical problems mentioned, the detection of myocardial ischemia is the most helpful and lifesaving because if it was not previously established, it could lead to death if proper management is not immediately done.


Gastroscopy is the process of inserting an instrument, called the gastroscope, through your mouth and reaching the inside of yourstomach. Through the gastroscope, the medical observercould now inspect the inner lining of your stomach, and he could find out if you are suffering from stomach ulcer or any new growth. If the new growth is suspicious looking, the medical observer could bite a piece from it using the gastroscope,   and the sample will be submitted to the laboratory for examination. With the aid of themicroscope, your new growth could be classified as either benign or malignant. If benign, then there is no problem; however, if malignant, then you may either undergo surgery or chemotherapy or both. In addition, if you have a bleeding ulcer, using the gastroscope, the medical observer could inject a medication in and around the site to stop the bleeding.


(To be continued)

What are the components of your annual medical examination? (Part 4)

Laboratory examinations

Blood chemistry analysis

Low-density lipoprotein (LDL) cholesterol

TheLDL cholesterolis one of the lipids that needs to be determined when you submit yourself for blood chemistry examination. This type of cholesterol is also known as the bad cholesterol because if its high level in the blood is not checked, it will be deposited in the different organs of the body, such as in the small and large blood vessels, and it will lead to hypertension and diseases of the heart. Hence, there is an urgent need to periodically measure its level in the blood, and if it is elevated—that is, higher than the normal values, you need to take medication(s) that will lower it.

High-density lipoprotein (HDL) cholesterol

The HDL cholesterol is also known as the good cholesterol because it is responsible for the so-called reverse cholesterol transport, wherein it carries back and returns all the cholesterol from the different parts of the body   to the liver for use and elimination. If cholesterol is not returned to the liver, it will be deposited in different parts of the body leading to the development of diseases of the blood vessels and the heart.

If the level of your HDL cholesterol is low, and your LDL cholesterol is low or normal, then there is no problem. Problem arises when your HDL cholesterol is low, and your LDL cholesterol is high! In this instance, you need to lower your LDL cholesterol by taking synthetic medication(s), and, as much as possible, increase your HDL cholesterol by having periodic physical exercises.

Blood uric acid

In one of the biochemical reactions taking place in your body, uric acid is produced as one of the products. If the enzymes responsible for eliminating uric acid from your body is adequate,the said substance will be adequately removed from your systems. However, if you lack the necessary enzymes, you will retain much of the uric acid, and this will be deposited in your joints causing excruciating pain every time you move your legs and hands. If the level of your uric acid in the blood is high and very much above the normal ranges, and if you have been experiencing pain in your joints, you medical doctor will prescribe you with the necessary medication(s). However, if theuric acid level in your blood is high, but you do not experience pain in your joints, then your medical doctor may still refrain from prescribing you with the necessary medication to eliminate your excess uric acid.

In extreme situation wherein some deformities have been formed in your joints resulting from the deposition of too much uric acid, then it can be said that you have been suffering from gout. In addition, elevation of uric acid in the blood for so many years will lead to the destruction of your kidneys. Hence, periodic measurement of your blood uric acid is a must.

Aspartate aminotransferase

Aspartate aminotransferase (AST)is one of the enzymes that needs to be measured every now and then. It is used to find out if you have a medical problem either in your heart or in your liver. However, if the increase of AST is very substantial, it could mean a problem in the heart which could be fatal. Thus, if you have been experiencing chest pain, and if your AST is substantially elevated, then see a medical doctor immediately because, very likely, you must be suffering from a heart attack!In some instances, however, elevation of AST—especially if minimal or moderate in amount—could mean a problem in the liver or in some skeletal muscles.

(To be continued)

What are the components of your annual medical examination? (Part 3)

Laboratory examinations


Other important findings in the urinalysis that you need to pay attention to are the presence of protein and/or sugar. If sugar is present in your urine, then it is highly possible that you have been suffering from diabetes mellitus (DM); if protein, on the other hand, is present, then you may have problem in your kidney(s), which could be inflammatory in nature. Thus, although it is cheap, your medical doctor could derive valuable information from itregarding your health, and he could start managing your medical problem at the earliest possible time.

Blood chemistry analysis

Fasting blood sugar

Fasting blood sugar is also known as the FBS. This test will let you know whether you have been suffering from DM or not. If your urinalysis reveals that you have sugar in your urine, then it is a must that you have FBS test so that you could confirm if you really have DM. More often than not, if you have sugar in your urine, you will have, at the same time, elevation of your FBS, signifying that you have been suffering from DM.

If your FBS is slightly over the normal values, your medical doctor may not start you at once with synthetic drugs. Instead, he will advise you on the right diet.Frequently, these are the initial and practical changes that you need to effect in your diet: (1) reduce your intake of rice, (2) refrain from adding sugar in your coffee, (3) avoid ice cream, chocolates, and candies, and (4) stop taking soft drinks. In addition, you need to have regular physical exercises.

Blood cholesterol

High level of cholesterol in your blood has been linked with the development of atherosclerosis and arteriolosclerosis (deposition of fatty plaques in the big and small blood vessels, respectively). When this happens over several years, the opening of your big blood vessels become narrow and their walls become inelastic, leading to the development of hypertension, or elevation and rise of your blood pressure. Thus, to prevent hypertension from taking place, the moment you find out that your blood cholesterol level is above the normal values, you need to consult your medical doctor, and take the medicine(s) that he will prescribe for you. Take it(them) daily so that hypertension will not set in.

If the deposition of fatty plaques takes place in the smaller blood vessels, such as those that nourish the heart muscle, then it is possible that you will have significant reduction in the amount of blood that goes to your heart, otherwise and medically known as myocardial ischemia, and you could be a victim of heart attack! Depending on the extent and amount of heart muscle that is deprived with blood, you may survive or die from it!

Blood triglycerides

Blood triglycerides are forms of fat (lipid) substances. They could be considered as “cousins” or “close relatives” of   blood cholesterol. Being “close relatives”, elevation of triglyceride level in the blood will also lead to the development of hypertension and diseases of the heart. In short, the adverse effects of elevated triglyceride level in the blood is the same as in cholesterolelevation; and when the two substances are simultaneously elevated, the development of diseases in the heart and blood vessels will develop faster than when only one is elevated. Thus, elevation of both the cholesterol and triglyceride levels in the blood is a bad sign! You need to consult your medical doctor soonest so that he could   prescribe you with the necessary medication(s) and advise you on the right diet and physical exercises.


(To be continued)

What are the components of your annual medical examination? (Part 2)

Laboratory examinations

Complete blood count

Complete blood count (CBC) is a very simple laboratory procedure, but it could reveal a number ofongoing and persistingmedical problems. One important value that is shown in yourCBC is the hemoglobin content of your blood cell.If the hemoglobin value is below the normal ranges, then you are suffering from anemia;since anemia could only be a tip of an iceberg—so to speak—you might need other laboratory procedures which will help your medical doctor determine what has been causing it.

The other value included in the result of your CBC is the number of red blood cells (RBCs). As mentioned in the previous articles of Powertec, the RBCs transport the oxygen from the lungs and bring carbon dioxide to the lungs. If the number of RBCs is reduced, then you will have a problem in the transfer of both oxygen and carbon dioxide, and you will get tired so easily. You cannot participate in very strenuous activities. Similar to the hemoglobin value, reduction in the number of your RBCs means a lot; it could mean a serious disorder in the blood.

The number of white blood cells (WBCs) is also shown in your CBC. If the number is very much higher than the normal values, then it is possible that you are having infection. If very much lower than the normal values, then it could mean a disorder in the bone marrow—an organ of your body responsible for the production of the different cells of your blood.

The platelet count is also included. To let you know, the platelets are the cellular components of your blood which are needed for producing a clot when any one of your fingers or toes is cut. If your platelet count is low, you are prone to have excessive and prolonged bleeding; but the problem does not stop there; a low platelet count could mean a possible disorder in the bone marrow. In addition, if you have been experiencing moderate to high fever for the last few days, and if your platelet count is low, then it is possible that you are suffering from dengue fever, especially if you come from tropical countries.

If your RBC, WBC, and platelet count are all below the normal values, then the possibility of having problem in the bone marrow is very high. You need to consult a hematologist—an expert in the diseases of the blood.



When urinalysisis done, you need to collect your urine, and it will be submitted to the laboratory for examination within one hour from the time of collection. This laboratory procedure is very cheap and can be done in a short time; however, a lot of information can be gleaned from it.

Normally, RBCs are not found in the urine. However, if they are present, then a number of possibilities could be considered. One important problem that you may have is the presence of stone either in your kidney(s) and/or urinary bladder. However, your medical doctor will ask you more questions to firm up the consideration of this problem.

If, in addition to RBCs, you have pus cells in your urine over the normal values, then it is possible that you have infection in the kidneys and/or urinary bladder or both.This consideration is highly probable if bacteria are found in your urine. Again, your medical doctor may ask some more questions and/or require other tests to confirm and establish that you really have infection.


(To be continued)

What are the components of your annual medical examination? (Part 1)

Importance of the annual medical examination

There are three important factors that play vital roles in your health maintenance: (1) adequate physical exercises, (2) well-balanced diet, and (3) submission to annual medical examination (AME). In previous Powertec articles, the first two factors have been well covered and adequately discussed that now the third factor needs to be given the same treatment and attention as the previous two.

The AME could be likened to a scanner which is used to examine and view the whole forest. The forest is composed of different trees, and you really do not know, at a certain time, which tree, or trees, has (have) problem(s). If you scan the whole forest, then you could find out the problematic trees, and, therefore, you could implement preventive measures which will slow down the worsening of their condition. By the same token, your body is composed of different parts and organs, and, at certain time, you really do not know which of your organs have problems. There are times when, without feeling any unpleasant experiences, some of your organs have been having problems. But because they are at the earliest stages of a disease, you do not feel anything bad, and you still feel good and alright.

Following the principles of preventive medicine, you need to have the AME so that your medical doctor will be properly guided on how to implement preventive measures for your health.Without the AME and without its results, your medical doctor will have a hard time knowing your future medical problems; he is lost in the jungle, so to speak; thus, he cannot implement preventive measures at the earliest possible time.

Parts of annual medical examination

History taking

If you will meet your medical doctor for the first time, this part of AME may take some time because he will build up your baseline data from zero. He will get general data from you, such as your name, age, address, place of work, and so on. This is followed by your past history, which is concerned with your past illnesses, previous hospitalizations and surgical operations; your personal history, which is concerned with your personal lifestyle and habits, such as drinking liquor, smoking cigarettes, and other practices and preoccupations which have detrimental effects on your health. Subsequently, your family history will be looked into, searching for the diseases which have been common in your family members, such as hypertension, diabetes mellitus, bronchial asthma, and other diseases. You will asked about the cause(s) of deaths of thedeceased members of your family.

Physical examination

After takingdown your medical history, the medical doctor will then physically examine you. Through inspection, he will look at you, and note down all abnormalities. He will observe how you walk and smile; he will note the color of your skin, eyes, and your tongue. After inspection, he will do palpation wherein he places his hand over your chest,  abdomen or any part of your body, and he will feel for any abnormalities. This is followed by percussion wherein the medical doctor taps any part of your body through the use of his fingers, and feel for any change(s) in the sound emitted by the percussed organ(s). Through auscultation, he will listen to your heart, lungs, and abdomen by using his stethoscope. At the end of the four processes, he will collate all the data that he collected, and he will establish a working impression and tentative conclusion—whether you are totally okay or you have a medical problem.

(To be continued)


Basic description and management of pain(Part 5)

Drugs used to control “pain”

In the management of pain, there are several methods being used, and one of them is synthetic drugs. In the ensuing part of this paper, the different classes of drugs being used to control pain are introduced and discussed. This is meant to give you an overall view of what drugs could be used to control your pain. Before you use any one of these drugs, however, you need to consult a medical doctor who will guide you on how to approach your problem in terms of knowing what is causing your pain and what drug to use in controlling it.

Non-opioid analgesic[1]

The frequently used members of this group are the following: paracetamol or acetaminophen, aspirin or acetylsalicylic acid, and the non-steroidal analgesic drugs (NSAIDs). Taken as a group, the following generalizations can be applied to each and every member: (1) by taking the drug(s), you will not develop addiction to it (them), (2) there is a “ceiling” to their analgesic effect—that is, upon reaching a certain dose, increasing it will not lead to further relief of yourpain, (3) the capacity to reduce your body temperature, provide relief of yourpain, and control whatever inflammation you have been experiencing varies from one drug to another within the group, and (4) they provide you withpain relief by preventing the formation of prostaglandins[2].

Prostaglandins are hormone-like substances which participate in the performance of your different body functions, such as the contraction and relaxation of your muscles, the dilation and constriction of your blood vessels, and the modulation of inflammation [3]. By modulating inflammation, it could worsen yourpain; thus, the prevention of its formation would lead to the relief of yourpain.

Paracetamol or acetaminophen[2]

Generally, paracetamolor acetaminophen is used to reduce your body temperature. Thus, when you are having fever, this drug is prescribed to you and to othersby a relatively large number of medical doctors. Aside from this, however, youcan use it to control yourpain. This drug is relatively safe, cheap, and very effective; hence, you are encouraged to use this as the first line drug to control yourpain. However,if you have a history of stomach ulcer and hyperacidity (too much acid in the stomach), you are advised to be more cautious in using it; if none, this medication is generally safe and largely deprived of any life-threatening reactions to your body.

To avoid confusion, you should remember that this drug has two generic names: paracetamol or acetaminophen. In some countries, drug dispensers know paracetamol, but they are not aware of acetaminophen; in other places, however, acetaminophen is well-known as the generic name of this drug.

Aspirin or acetylsalicylic acid[2]

Aspirin or acetylsalicylic acid has the same actions as paracetamol. The main difference is on the possible side-effect. Aspirin is notorious for causing possible bleeding from your stomach when it is used for a long time. Thus, you should exercise extreme caution   when using it. To play safe, useparacetamolif you are not allergic to it, instead of aspirin.

Non-steroidal analgesic drugs (NSAIDs)[2]

If acetaminophen (paracetamol) or aspirin will not be able to relieve your pain, then you can shift to using the NSAIDs. Examples of NSAIDs arediclofenac,ibuprofen, naproxen, celecoxib, mefenamic acid, etoricoxib, and indomethacin[4,5].If you use thesedrugs on a short-term basis, they could be considered as generally safe; however, you need to be more careful if you use them for a long period of time, bearing in mind always their possible side-effects on the kidneys and the inner lining of the stomach [1].

Weak opioids [1]

When the non-opioid analgesics or NSAIDs could not fully control your pain, then the so-called weak opioids, such as codeineandtramadol[6], could be added or could be used as replacement. The purpose of adding the weak opioid is to avoid maximizing or increasing the dose of the non-opioid analgesics or NSAIDswhich could be detrimental to your health[7].

Strong opioids [1]

Strong opioidsare the ultimate treatment for moderate to severe pain. When everything has been tried on you and yet no palliation of pain is observed, then the strong opioids will be resorted to. Examples of strong opioids are morphine[6]and oxycodone.

(Last of a series of 5)


[1]Mercadante S, Fulfaro F. World Health Organization guidelines for cancer pain: a reappraisal. Annals of Oncology 16 (Supplement 4) 2005: iv132-iv135.

[2] Melmon, Kenneth L., Howard F. Morrelli, Brian B. Hoffman, and David W. Nierenberg. Clinical Pharmacology, Basic Principles in Therapeutics. McGraw-Hill, Inc., Health Professions Division: New York, 1992.


[4] NSAID (List of non-steroidal anti-inflammatories).

[5] eMedExpert, Non-steroidal anti-inflammatory drugs comparison.

[6] WHO analgesic ladder: which weak opioid to use at step two?

[7] United States. U.S. Department of Health and Human Services, Public Health Service, Agency for Health Care Policy and Research, Clinical Practice Guideline, Number 9, Management of Cancer Pain, Rockville, March 1994.


Basic description and management of pain(Part 4)

Management of “pain”

Steps to undertake when experiencing “pain”

Determine the cause(s) of “pain”

For every pain that you experience, there is a cause or set of causes. Initially, by yourself, you may be able to determine the cause or causes. However, if you have a hard time doing it, then you need to consult a medical doctor who will help you find out your problem and prescribe you with the necessary medication(s).To help your medical doctor, pay attention to the details of your pain. You should fully describe it in terms of location, time of occurrences, intensity, aggravating and relieving circumstances, and whether it stays in one location or spreads to other area(s).

Have the necessary rest

If your leg or knee, for instance, is painful, you need to have rest. If you have scheduled gym sessions, you need to forego those activities for the moment. If you need to go out to buy something, probably it is better that you stay home and do it on a day that your aching part is no longer painful. There are times when your knees are painful because you are overdoing a certain activity, like running on a concrete road! While in pain, have rest.

Take your medications as prescribed

By the mouth[1]

When you experience pain and you have decided to take analgesic(drug to relieve pain), it is advisable that you take it (them) by mouth. It is easier to do it; you can do it by yourself. In addition, the occurrence of side-effects is lesser because the entry of the said medication(s) to your systems is not as fast as when you use injectable drugs.

By the clock[1]

If you were prescribed with a medication which should be taken every six hours, then take it every six hours. If you missed one dose at a certain time, then you will lack certain amount of the medication in your system, and you will experience the so-called breakthrough pain (BP). After you have been free from pain for several days or months, BP all of a sudden takes place because you lack the necessary medication(s). To prevent this, takeit (them) as prescribed and as scheduled.

By the ladder[1]

The World Health Organization (WHO) prescribes that the medication(s) to be used in treating pain should be selected based on the strength of the drug. In this method, medications for pain are categorized into the following: (1) non-opioid, (2) opioid drugs for mild to moderate pain, and (3) opioid drugs for moderate to severe pain. Based on WHO’sprescription—which is otherwise called as the “by the ladder” method—the first drug to be used should come from the non-opioid group, which include the paracetamol, acetaminophen, aspirin, and the non-steroidal anti-inflammatory drugs[1]. The opioid medications should only be used, and reserved, forpain that cannot be controlled by the non-opioid drugs.

For the individual[1]

Whatever dose of medicine you need, it is only good for you. It cannot be used by another person, for everyone inpain needs individualized dosage.

With attention to detail[1]

Pain treatmentrequires great attention to details. This means that you need to take note of when the pain occurs, what are the aggravating and palliating circumstances, the duration when it occurs, and other details that may help you and your attending physician. The correct determination of your medical problem—relatively dependent on what you tell the medical doctor—is of utmost importance because the ensuing medical management will highly depend on it.

(To be continued)


[1]United States. U.S. Department of Health and Human Services, Public Health Service, Agency for Health Care Policy and Research, Clinical Practice Guideline, Number 9, Management of Cancer Pain, Rockville, March 1994.