The Clinton Herald, Clinton, Iowa

Food & Health

October 31, 2013

Endocarditis and dental work

(Continued)

ANSWER: Warfarin (Coumadin and others) reduces the body’s ability to make blood clots by blocking the effect of vitamin K in the liver. So, substances that affect the liver’s ability to metabolize, such as Tylenol, or that affect the platelets, such as aspirin, tend to increase the propensity to bleed.

Fortunately, in most people, modest doses of pain medications still can be safe. Significant effect on blood clotting in people on warfarin is rare if taking less than 2,000 mg of acetaminophen (that’s four extra-strength or six regular tablets) daily. Most arthritis medicines are still safe on warfarin, but double-check with his doctor before he takes them. Tramadol also usually is safe.

DEAR DR. ROACH: I am a 61-year-old man. When I was 18, I had shingles. I was told at the time that now that I had them I would never have them again. I also was told that it meant I would no longer get cold sores, but I still have gotten those occasionally through the years.

I’ve recently been reading on the Web that shingles can re-occur, with up to one in three people having re-occurrences. I am now wondering if I should go ahead and get the shingles shot I keep hearing about. — J.D.

ANSWER: Yes, you should get the vaccine, as per the manufacturer’s and the Center for Disease Control and Prevention’s recommendations, even if you have had shingles in the past.

Cold sores are a related herpes virus, HSV-1. Unfortunately, the vaccine for Varicella-Zoster won’t help with oral or genital herpes.

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