CONSUMER HEALTH: NIACIN TO BOOST

BALANCING ACT

It is a balancing act with some risks. In August, friends sent Kressly screenshots of parents’ online message boards from states such as Texas, Indiana and Florida that were seeing a summer spike in COVID-19 cases. Mothers felt abandoned by their pediatricians because they were being sent to urgent care and emergency departments. Kressly fears some patients will fall through the cracks if they are seen by several different providers and don’t have a continuity of care.

Also, there’s the expense. Bryce’s case is a good example. Gudgeon reluctantly took him to an urgent care facility, worried about exposure and frustrated because she felt her doctor knew Bryce best. His exam included a COVID test. “They barely looked in his ears, and we went home to wait for the results,” she said, and got no medicine to treat Bryce. The next day, she had a negative test and still a fussy, sick baby.

Urgent care facilities across the country are reporting higher numbers of patients, said Dr. Franz Ritucci, president of the American Board of Urgent Care Medicine. His clinic in Orlando, Florida, is seeing twice as many patients, both children and adults, as it did at this time last year.

“In urgent care, we’re seeing all comers, whether they are sick with COVID or not,” he said.

Meanwhile, ERs are seeing far fewer pediatric patients than usual, said Alfred Sacchetti, a spokesperson for the American College of Emergency Physicians and the director of clinical services at Virtua Our Lady of Lourdes Emergency Department in Camden, New Jersey. Although adult emergency room visits have largely returned to pre-COVID levels, pediatric visits are 30% to 40% lower, he said. Sacchetti suspects several factors are at play, including fewer kids in daycare and school with less opportunity to spread illness and people avoiding emergency rooms for fear of the coronavirus.

“You see parents looking around the department and if someone clears their throat, you can look in their eyes and see the concern,” Sacchetti said. “We reassure them” that the precautions taken in hospitals will help keep them safe, he added.

Gudgeon considered taking Bryce to an emergency room, but she felt increasingly uncomfortable both with the thought of exposing him to another health care facility and the cost. In the end, she called an out-of-state doctor she had seen often years before moving to Illinois. That doctor phoned in an nervous system, digestive body to turn food into energy. antibiotic prescription, and Bryce quickly improved, she said.

“I just wish he didn’t have to suffer for so long,” Gudgeon said.

Kressly hopes doctors become more creative in finding ways to provide direct care. She likes the “Swiss cheese” approach of layering several imperfect solutions to see patients and offer protection from COVID-19: screening for symptoms before the patient comes in, requiring everyone to wear masks, allowing only one caregiver to accompany a sick child and offering parking lot visits for sick kids in their cars.

Most important is good communication, Kressly said. Not only does that help the patient, it can also help protect the doctor from patients who may not want to admit they have COVID symptoms.

“We can’t create this barrier to care for uncomplicated, acute illnesses,” Kressly said. “This is not temporary. We all have to creatively figure out how to get patients and families connected to the right care at the right place at the right time.” — Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent

CONSUMER HEALTH: NIACIN TO BOOST YOUR HDL, ‘GOOD,’ CHOLESTEROL

Mayo Clinic News Network

Niacin is an important B vitamin that may raise your HDL, (“good”), cholesterol. Find out if you should talk to your health care provider about taking niacin alone or with cholesterol medications.

Niacin, a B vitamin, has long been used to increase highdensity lipoprotein (HDL) cholesterol — the “good” cholesterol that helps remove low-density lipoprotein (LDL), the “bad” cholesterol from your bloodstream.

But niacin isn’t for everyone. People who take niacin in addition to common cholesterol medications see very little additional benefit. And niacin can cause uncomfortable and sometimes dangerous side effects.

What is niacin?

Niacin (nicotinic acid) is a B vitamin that’s used by your Niacin also helps keep your program of the Henry J. Kaiser Family Foundation.

system and skin healthy. That’s why niacin is often a part of a daily multivitamin, though most people get enough niacin from the food they eat.

When it’s used as a treatment to increase your HDL cholesterol or correct a vitamin deficiency, niacin is sold in higher doses that are prescribed by your health care provider. Prescriptionstrength niacin includes such drugs as Niacor and Niaspan.

Niacin is also available as an over-the-counter supplement. Supplements sold over-thecounter are not regulated like prescription medications. The ingredients, formulations and effects of over-the-counter niacin can vary widely.

Don’t take niacin without discussing it with your health care provider first because niacin can cause serious side effects when taken in high doses.