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Episode 13: The Best Way to Handle Holiday Stress

Put down the Xanax. This week, MedShadow Founder Su Robotti and Content Manager Jonathan Block talk about using easy forms of meditation to manage stress during the holidays.

Su Robotti: Hello and welcome to MedShatowTV. My name is Sue Robotti, and I’m the founder of MedShadow.

Jonathan Block: And I’m Jonathan Block. I’m the content manager for MedShadow.

SR: Today, we’re going to talk to you about stress. We’ve been feeling a lot of stress. The holidays are coming, and stress is caused by too much food, too many relatives, too much pressure, too much gift shopping, too much drinking.

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The key here is too much. Today, we want to help you take it down a notch, calm down, and we want to help you do that through meditation.

First of all, what is stress? The physical response to a stressful situation is adrenalin and cortisol enter your bloodstream. It increases your blood pressure, and your heart rate starts to go stronger. And if this isn’t dealt with easily or quickly, and it continues for a period of time, it can lead to gastrointestinal problems. It can lead to heart disease. It can lead to brain dysfunction like I’m having now. It can lead to a lot of long-term issues with heart disease and gastrointestinal problems among other things.

But Jonathan, what do you suggest we do? Should we pop a pill? That would be very quick.

JB: Absolutely, don’t. You’ve actually alluded to it, and that was through meditation, which is the main part of an idea known as mindfulness, which is defined as being aware of the present. I mean, I know what a lot of people are thinking — the same thing that I was thinking when I heard the word mindfulness. That just sounds like a whole bunch of new age hooey.

SR: Hooey?

JB: Hooey.

SR: Okay.

JB: I’m going old school. I can tell you from a personal experience as somebody who’s dealt with stress, and anxiety, and depression. Meditation associated with mindfulness actually does work. It works well.

And why don’t you take a pill? Because pills have side effects.

Mindfulness meditation — and we’ll be discussing this in a little bit — there are clinical studies that have demonstrated that mindfulness meditation can be used for a number of different conditions avoiding these sort of drugs, which as our MedShadow audience knows, most of which — if not all — are associated with side effects, drug interactions, or other nasty effects.

SR: In fact, is meditation as effective as antidepressants?

JB: Yes, it is. There’s been, I want to say, 40 to 50 clinical studies done just on comparing mindfulness and meditation with antidepressants. They’ve all come to the same conclusion. Mindfulness meditation is as effective as antidepressants.

So why — I know what you’re going to say. I’m going to read your thoughts. But why not just take a pill, right?

SR: Why not?

JB: I know that’s the easy way to go out. The thing is is that as I just mentioned, antidepressants and other antianxiety pills like the Xanax or the Valium that some people in our audience may be taking, have taken, or thinking about taking.

Mindfulness meditation is something that you can teach your brain how to think. It helps you relax without the use of drugs, and therefore you can learn how to deal with stress and anxiety over the long term. It’s actually much better for you, because you’ll actually train your brain how to better handle stress and anxiety but without the nasty side effects of a pill which means it is harder work.

But in the long term, the long-term efficacy of it has been demonstrated whereas with antidepressants, we know that people develop problems, and they lose their efficacy. And for some people taking antidepressants and anti-anxiolytic drugs, they just aren’t even effective anymore.

SR: So let’s take a breath.

JB: Yes.

SR: And how do you meditate? Do you have to sit cross legged? Do you have to hold your fingers in the air? Do you have to say, “Ohmm”?

JB: No, you’re thinking of some of the Buddhist meditation. But this type of meditation like the meditation that pretty much busy people or people that don’t want to go, “Ohmm,” want to do — can take as little as 10 minutes.

That’s what I do a day. I only do 10 minutes. I do some breathing exercises. There are also ways which if you learn more about mindfulness and we’ll provide you with some information about that in a second — the mindfulness, actually, you train your brain to relax. I know this sounds weird, because I didn’t believe it until I started doing it. And then in the words of a great Monkees song, “I’m a Believer,” and I’m a believer now about how effective mindfulness is and how effective mindfulness meditation is as well.

SR: So do you take classes? How do you learn to do this?

JB: I do a combination of things. I have read some books. There’s an excellent website that is operated by the fine people at UCLA known as the UCLA Mindfulness Awareness Research Center. That address is http://marc.ucla.edu. They actually have free relatively short meditations that you can download and listen to, and you can start on your own.

There’s another resource that I use a lot. This is a paid resource. It’s an app, and you can also do on your computer called Headspace. But I pay — I find it particularly effective. I looked at a lot of them, and I find Headspace — just to let the audience know, neither Headspace nor UCLA has asked us to mention them. This is just from my own personal experience.

SR: And then I’ll add one that’s free that I use; it’s called Breathe. But there are many, and you’ll find the one that you like if you just Google guided meditations, and you’ll find it.

I started meditating by simply becoming quiet and not using guided meditation — just setting a timer and trying to still my thoughts calmly for 3 minutes at a time. I got up to 5 minutes. And honestly, guided meditation is much easier.

JB: Oh, yes.

SR: And I would like to graduate to regular quiet meditation. But for now, I’m finding that I become more calm and happy using the guided meditation.

JB: And if you’re a novice — I still consider myself a novice — I find that the guided meditation works a lot better.

Just one other point because I know we’re talking a lot about this. It’s that mindfulness meditation is actually good not only for — works well, I should say — works not only well for depression, anxiety, and stress, but it’s been shown that people that want to lose weight through practice of mindfulness meditation, they can actually teach themselves to eat less.

SR: Eat less during meditation?

JB: No, afterwards, because they train their brain.

SR: You mean through their mindfulness.

JB: Right, because they think — like they ‘think before.’ You’ve heard the term, “Think before you act.”

SR: Uh-hum.

JB: You teach yourself how to think before you eat, and you’re more careful at what you eat. But just by taking a few — by doing 10 minutes of meditation every day and then when you go and decide to have your meal, people who have done meditation and mindfulness, they train their brain to think, “Maybe I don’t need that side of French fries. Maybe I should get a side of quinoa or something of that nature, something of a more healthy starch.”

SR: Yes. My downfall is more of when I’m in a family situation, and there’s cheese, and crackers, and nuts, and all these good stuff in front of me, and I find I’m eating without thinking. I think you’re going to tell me that that’s not mindful.

JB: It’s not mindful, but everybody is allowed during the holidays to cheat a little bit. The thing is not to make it a regular part of your life. And even if you just have a few — if you — let’s say you cut out — maybe you only eat nuts, but instead of reaching for the Ferrero Rocher chocolate, maybe in parties you might have had 3. Now, maybe you’ll only have 1. That’s even mindfulness just like making even a slight change. And then as you get better and better at mindfulness and meditation, you’ll learn to control yourself better.

SR: Okay. So instead of taking a pill, instead of eating chocolate, instead of taking a long hot soak in the tub, what we’re going to do is try meditating to de-stress.

JB: Actually, taking a long hot soak in the tub is actually very good.

SR: Soak in the tub — we’re saying yes to this.

JB: We are saying yes to that.

SR: What about taking a walk or a jog?

JB: Also excellent.

SR: Okay.

JB: Just lose the medications and go easy on the chocolate.

SR: Okay. Do that and have a great holiday.

JB: Yes. From all of us here at MedShadow, thank you for making MedShadowTV, which just premiered this year, such a wonderful success, and a happy holidays to you and your family. Take care.

Episode 12: The 21st Century Cures Act

Su Robotti: Hi, I’m Su Robotti, and I founded medshadow.org.

Jonathan Block: And I’m Jonathan Block, MedShadow’s content manager.

SR: Today, Jonathan and I are going to talk to you about the 21st Century Cures Act. This Act has a lot of good aspects to it. The 2 primary benefits to it are that it would send millions of dollars to the National Institute of Health for drug development and testing. The other good aspect is that it will lead to faster approval for drugs, so they get to the marketplace and to saving lives more quickly. Presently, it takes a lot of time and money for a drug to get to marketplace. It has 3 levels of clinical trials. It can take years, and millions, and millions of dollars.

Jonathan, are we asking too much of the drug companies with this?

JB: Absolutely not. In the effort to rush new drugs to market, pharmaceutical companies under this legislation will have to skimp on clinical trials. What do I mean by this? It means that the trial durations would be shorter, and the number of people enrolled in the trials would be shorter. My fear is that by doing this you may not be able to find out certain side effects, because you’re using smaller patient population for much less time. And as we’ve seen in the past in this country, even drugs that have gone through extensive testing, you discovered issues with them later on. The most notorious example would be the pain drug, Vioxx, which led to heart problems and was ultimately withdrawn from the market.

SR: The other problem with having shorter clinical trials with fewer people involved in them is that it doesn’t allow enough patients in the trial to discover, to include subgroups — subgroups like women, or elderly, or teens, children, subgroups like pregnant women, or Hispanic, Latino, African-American, or African. And the problem with that is that drugs often synthesize differently in different people.

A great example is Ambien, the sleeping drug. It was tested primarily on men; it tested very well. And when they woke up in the morning, they were refreshed and felt great. But when it went out into the marketplace approved for everybody to use, women used the drug and woke up not refreshed; they woke up groggy. It led to a lot of car accidents, a lot of confusion, a lot of lawsuits until ultimately Ambien’s directions had to be changed and the dosage lowered for women.

If the clinical trials had been set up to include different subgroups of people and identify within those subgroups how it acted differently, we could have avoided many deaths and a lot of lawsuits. So how long does it take for our drugs to get to the market today? Is it too long?

JB: It actually isn’t too long. I have some statistics here that kind of indicate that it’s not as slow to approve many drugs as it has in the past. Sixty percent of the drugs that were approved in 2015 were approved — what’s known as in an expedited review through terms known as fast track priority and accelerated approval. That means that they came to market much faster compared to the normal drug approval process. Also, about half of those drugs that were approved were for drugs to treat rare or orphan diseases. Those are diseases that relatively few people suffer from. So there a lot of new drugs that are coming out on the market. For example, last year, there were 45 of them, and that’s actually a pretty good number for the FDA.

SR: One last thought – post-approval. When the drug is finally approved and goes to marketplace, under any circumstances, we believe that there needs to be a much more rigorous and well-financed post-approval study process. It takes too long for the FDA to find out through population trials that a drug is causing harm or isn’t acting effectively.

JB: I just want to add one thing to that and that becomes even more important when the initial clinical trials if this legislation passes are going to be even shorter and skimpier than they are in the past. That just makes post-marketing trials that much more important and why they need to be funded much better.

SR: So for these many reasons, we’re hoping that the 21st Century Cures Act gets looked at very, very closely. For more information about 21st Century Cures Act and the side effects of the medicines that we all take every day, please go to medshadow.org. Thank you.

Episode 10: Disease Mongering

This week, Su Robotti and Jonathan Block discuss Disease Mongering. That’s when pharmaceutical companies take an everyday discomfort and promote it to a disease — and then seel meds to cure the disease.

Su Robotti: Hi. I’m Su Robotti and this is Jonathan Block. We’re both from MedShadow. I’m the founder and Jonathan is the content manager.

Today, we’re going to talk to you about conditions of life that somehow are becoming elevated into diseases. When I was a kid, watching TV, there was this terrible disease that was going through a scourge of the nation. It was halitosis. And everybody had to use Listerine to get rid of it. When my vocabulary expanded, I found out it was bad breath and that good dental care and brushing your teeth and not eating onions would take care of most cases, most times, of bad breath. So it wasn’t really necessary to take medicine or anything.

But that was the beginning of a wave of products that pharmaceutical companies had developed, to take everyday aging or life occurrences and are turning them into diseases. And were very concerned about this, aren’t we?

Jonathan Block: Yeah. What you’re talking about is something called disease mongering, which is taking conditions that are just common, everyday occurrences — sometimes they’re just the consequence of aging — and turning it into something where you think it’s a serious medical condition that if you don’t have it treated, it’s going to significantly impact your health or well-being. You were just talking about restless leg syndrome.

There’s a drug out there called Requip and that was originally developed for Parkinson’s disease and it got a secondary indication for restless leg syndrome. And in most cases, most people that have been diagnosed with restless leg syndrome really don’t have that condition. A very small percentage of people actually have it. Most of the time, if you have restless legs, it might be because you don’t have enough sleep, you’re suffering from stress or anxiety, or you’re maybe drinking or smoking too much.

SR: You mean too much coffee?

JB: Exactly, so put that cup down.

SR: Sorry. You’re right. What about esophageal reflux disease?

JB: AKA acid reflux?

SR: You mean gas?

JB: Exactly.

SR: And do you have to take a medicine for that?

JB: No, that could be a consequence of eating spicy foods. Some people are just more sensitive to eating certain foods. There’s a very easy way to take care of that.

SR: Do you imagine there are 5 jalapeno poppers?

JB: Probably not because not only would that affect your stomach it will probably raise your cholesterol a great deal.

SR: Thank you for taking care of me. What else is a made-up disease or an exaggerated symptom into a disease?

JB: A good one is the drug called Addyi which is for something called, I have to look at this, hypoactive sexual desire disorder. This made the news last year when the drug was approved. It called the “female Viagra.” The drug company decided that since men had Viagra and other similar drugs for erectile dysfunction, that there should be a similar drug for women. It had very tenuous–

SR: Research.

JB: Research, thank you, conducted for it. And the good news with this one is that since it’s been on the market, the drug has kind of bombed. It hasn’t really been selling very much as doctors realized that it’s not a real condition and the drug itself doesn’t work at all.

SR: The issue with a lot of these diseases are that once you start with the cure, with the medicine, even sleeping aids, there’s a rebound effect that will keep you from not using it. If you quite often, if you use a sleeping aid, and by then the other kind of ones or the prescription ones, the next night, you will have more trouble getting to sleep, and therefore, need it again, and the following night, and so forth, because you’ve interrupted your natural sleep pattern.

What about overactive bladder?

JB: Well, that’s another condition that is a consequence of getting older. There were pharmaceutical companies that decided to elevate that from just kind of an inconvenience or annoyance to, again, something more serious that required medical attention and necessitate taking a prescription drug.

One thing that we haven’t addressed with all of these drugs for questionable conditions is that many of them have side effects. Another class of drugs that has come on the market recently are so-called Low T or low testosterone drugs, which is really more of a “lifestyle drug” but doctors have said that Low T isn’t even a real condition. And taking one of these gels which you would actually just put on, rub on your skin, it gets absorbed that way, actually doesn’t do much in terms of increasing your sexual health. And they do come with several risks, most seriously is the risk of coronary artery disease. So it’s important that for some of these conditions that are very, very questionable, that there are serious side effects with the drug associated with them.

SR: If you like to learn more about the side effects associated with the drugs that you’re discussing with your doctor or that you’re seeing on TV, please go to www.medshadow.org, and just search for the drug. It’s very likely, we have something to say about it.

In the meantime, taking a drug for a condition that is not serious and not life threatening or that can be treated in a lower tech way, is just plain dangerous. So please, think carefully and balance the risks and the benefits of every drug you take. Thank you.

Episode 9: Outgrowing Allergies

In this episode, Su Robotti and Jonathan Block talk about the fact that children often outgrow allergies. Parents should have their children tested as often as every year. And maybe paying for that emergency EpiPen is unnecessary.

Su Robotti: Hello and welcome to MedShadow TV. I’m Suzanne Robotti and I’m the founder of MedShadow. This is Jonathan Block our content manager. And today, we’re going to talk to about children’s allergies.

I have a kid who, very early in life — he was about 4 — was told by his pediatrician that he’s allergic to shellfish and to avoid it, to never eat shellfish. And, my kid took this very seriously except that he loved shellfish. We would have lobster and he would try nibbling on a piece of it, and we’d watched him carefully, and he seemed fine.

So over the course of a couple of years, he started eating lobster and then he decided that he was only allergic to shrimp and crab. We told him he wasn’t allergic shellfish but he wouldn’t believe us. So, then he started nibbling on crab and that worked out well. Then he decided he’s only allergic to shrimp and, as you can imagine, ultimately, he is not allergic to shellfish at all. So foolishly, it was our fault. We never had him truly tested for shellfish allergy, and he was denied for many, many years of foods that he loved and are very good for him.

So Jonathan, what do you have to say about that, what’s your advice?

Jonathan Block: Well, we just had an article a few weeks ago in MedShadow by our freelancer Padma Nagappan, and she was telling the story about how her own 2 sons outgrew their allergies. In her article, which I encourage viewers to read on medshadow.org, she talks about how her 2 sons were diagnosed with peanut allergies when they were very young and, up until this year, they were required to have the EpiPen — which of course, has been the news lately — in case their kids would have any sort of allergic reaction.

And as we know, because it’s been in the news, that particular medication is quite expensive. So she decided to actually have her 2 sons tested to see if they were still allergic to peanuts, and guess what, neither of them are actually allergic. They outgrew their allergies.

SR: I didn’t know you could outgrow a food allergy. So you’re saying my kid might actually have been allergic to shellfish at one point but he just outgrew it.

JB: That’s correct. Padma interviewed a specialist who  is an expert in food allergies and according to this expert, about 80% of children that initially had allergies to milk, soy, egg and wheat outgrow them by the time they become teenagers, and another 20% will outgrow peanut allergies and about 15 to 20%  will outgrow allergies they may have had to shellfish or fish.

SR: Wow! That’s great. But why test kids? I mean, if you can afford them, why not just keep avoiding foods if you think you’re allergic, you can live a long life.

JB: Well, while that may be true, the fact of the matter is a lot of these foods are nutritious. Obviously, milk has a lot of excellent vitamins and minerals. And then the other thing is that you’re spending money on EpiPen or some other kind of drug for your child’s allergy, but the thing is that your child may not even have that allergy anymore, so you’re wasting money on medication. And all medications have side effects as our viewers are aware, and so, you’re potentially leaving your child open to side effects from the drug that they’re taking for an allergy that they may not even have anymore.

SR: And you’re creating an aura of fear in the child’s life that is just unnecessary. So I guess to take away from this is have your children tested for this allergies that they used to have, you believe they didn’t have. How often do you test?

JB: You can actually do it as often as every year. As children get older, their allergies can change. Whether they have it or not can actually change year over year, so you can actually do it as often as every year.

SR: Great. Okay, thank you, any other information we should have on this article?

JB: Well, I just encourage our readers — sorry our viewers — especially those who may have children with allergies, to read the excellent feature article by Padma Nagappan.

SR: Thank you Jonathan and thank you for watching MedShadow TV.

Episode 8: Informed Consent

Can a 7-year-old give informed consent regarding a prescription medicine? Su and Jonathan discuss this awkward question.

Su Robotti: Hi, I’m Suzanne Robotti, the founder of MedShadow, and our content manager is Jonathan Block We’re here today to talk to you about informed consent in children.

If you are at the doctor’s office, and your doctor is prescribing antibiotics for your 9-year-old, do you ask your 9-year-old for his or her opinion? Do you ask a 7-year-old if she wanted shots? I don’t know, but the American Academy of Pediatrics is suggesting that, yes, the child should have a role in informed consent.

Informed consent has a long history and a proud history. It’s a recognition by the medical establishment that the patient has a right, and even responsibility, to understand what medical procedure or medical care they are about to receive, and if the patient doesn’t want that care for any reason at all, that is the patient’s decision, not the doctor’s.

Children are different. Should they have a voice, Jonathan?

JB: I think that they should have a voice, but as far as the size of that voice, I think depends on a couple of situations. One is the age of the child. A lot of times you might get a 7-year-old, as what you said, if they wanted to get a shot, they’ll say no because it might hurt, but the benefits of getting a shot are obviously much better for the child. Where I could see informed consent coming into view, and I would support it, would be for adolescents or children that have gone through their lives, if they have had a major medical issue, they are more mature, they have a better understanding of what’s going on with them. And I think that when you’re of a certain age, maybe 12, 13, I think at that point you understand the benefits and risks of a certain medical procedure or medication, and that you should take a 12- or 13-year-old’s desires and opinions when making health decisions.

SR: Well the American Academy of Pediatrics came out with the statement that says children as young as 7 should have an opinion on their medical care in certain conditions, and my examples earlier were clearly exaggerated. The American Academy of Pediatrics does not suggest a 7-year-old be able to resist taking a tetanus shot. That’s really not a decision that they should get, a thumbs up or thumbs down, a vote on.

But, it did give as an example, medicine for ADHD, and it quoted a study that showed when parents and children were told together about the risks and benefits of ADHD medicine, the children showed as much comprehension as the parents in a quiz a few minutes later.

I’m going to be a wise guy here and say that that kid probably doesn’t need ADHD medicine in that case, but I’m being a wise guy. And that was an example where the AAP said, yes, the child should have a very significant vote there. Again, does that make sense to you?

JB: Yes, I think that in the situation that you just described, it is important to get, at least input, from the child. Just because a kid who’s 7 years old doesn’t mean that they’re completely absent from the conversation on their medical treatment. I think it’s important to have kids be informed as much as they can understand given their age. And I think it is important for them to understand, even at a young age, why the treatment is being given. And it also can have a longer effect in that if you started out with them understanding why certain medical decisions are made at an early age, it will likely them more likely to be better informed as they get older about health.

SR: Certainly they should understand the ins and the outs. There are a couple of cases where the medical community and, in most cases, the law agrees that the child can make decisions without any input from the parents with the parents not even knowing, and that generally speaking is, healthcare doesn’t do a sexual activity, anything having to do with contraception, sexually transmitted diseases, pregnancy. In most cases, medical communities say you can deal directly with the child without any parental involvement, and also in case of mental illness, or in substance abuse, the child definitely gets the say there.

JB: Well, I think it’s something, it’s also important to note that the American Association of Pediatricians said is that doctors themselves also play a role. Obviously if a kid is old enough and they say they don’t want a particular treatment, it doesn’t mean that the physician just gives up there. It’s actually the responsibility of the physician, both morally and legally to say, “Look, this is the best course of action. This is going to be important for your long-term health.” But of course that creates other difficulties because the reason why the child maybe objecting is because of religious or other kind of reasons. But the point is that doctors still have a role to play in advising children and their guardians, their parents, as to what the best course of action is.

SR: So our advice is read beyond the headlines because many headlines are saying 7-year-old’s now get decisions on medical care, and look carefully. It’s up to the doctor and the parent to involve the child so that they understand their medical care and at the appropriate time can take complete adult care themselves. So, work with your doctor who works with your child and please read MedShadow at medshadow.org.

Episode 7: Treating Lice

In this episode, Su and Jonathan discuss one of the downsides of the school year: lice. Few kids make it all the way through a school career without finding themselves scratching. What’s a parent to do? We have advice:

Su Robotti: Hi, I’m Su Robotti and this is MedShadow TV. I’m the founder of MedShadow Foundation and our content manager is Jonathan Block. Today, we’re going to talk to about—well I’m sorry, but we’re going to talk about lice, head lice. It’s an ugly topic, but let’s just start with what people keep reassuring each other. It does not mean you have a dirty home. It just means that you or your child shared a hat or a helmet or touched foreheads with somebody who happens to have lice. And you can get rid of them easily.

Lice are not dangerous, they do not carry disease. So Jonathan, what do we need people to know about lice?

Jonathan Block: Well, first thing is that they are a number of different treatments for lice. It runs the gamut from some natural treatments to some over-the-counter treatments, even some herbal treatments. I’m going to start with the over-the-counter treatments that many people may have heard of. It’s called Rid or Nix, they both have the same active ingredient, what’s called permethrin. It’s actually been found to be quite effective, it’s been on the market for decades, and there are a very few side effects associated with the Rid and Nix products.

SR: Let me just say, there have been, as far as we can tell, no long-term studies on the safety of Rid or Nix, but the American Academy of Pediatrics has determined that it’s been on the market long enough that theoretically we would have seen it, so they consider it safe. And they suggest it as a first line, the first line of defense, the first line of offense, the first thing you use. However, that may not be the best idea, why would that be?

JB: Correct. Obviously, you’re going to be using a drug product. And some people have also taken a look at using some more natural remedies for it. some of these include essential oils. However, there is a word of caution: If you’re going to try essential oils, they can sometimes cause skin rashes, depending, some people have allergies to them, so you have to be looking out for them. There’s a thought that there are several common treatments such as Vaseline, also known as petroleum jelly, olive oil and even mayonnaise. Yes, it’s not just meant for your sandwiches. However, much of the research has found that Vaseline, olive oil and mayonnaise are rather ineffective. Even though of you were to use it, the lice may appear dead after using one of these treatments, the fact of the matter is they aren’t actually dead. They’re just kind of inactive for a short period of time and then they come back to life in a term known as the resurrection effect.

SR: I love the resurrection effect. One of the reasons why we don’t encourage everybody to use Rid or Nix all the time even though it’s pretty effective and the AAP says it’s fine to do is because lice are developing resistance to it. The effectiveness of Rid and Nix, the ingredients in it, used to be in the mid-90s. It’s now down to probably mid-70s, and it’s basically because when people use it, sometimes they don’t use it exactly correctly, so that all the lice get killed which kind of selects the lice that have a natural resistance to the drug, to the medicine. They’re going to survive and breathe, and that’s how you get a resistance.

So it’s best to mix things up at least through our society, and use different types of medicines or methods. The other thing to keep in mind is that if you do use a Rid or a Nix or the other drugs that are considered safe and approved for lice removal which would include ivermectin, which is sold as Sklice and also spinosad, there are a few others your doctor can recommend. If you use them once, and they aren’t effective, don’t use them the second time. It’s going to help select the lice that will survive and create resistance. Move to a different type of drug. Or, just comb your hair out. Every person that I spoke with, every mother who’s in the school system now, says that they don’t use any kind of medicines on it. They use Pantene as a white conditioner, and comb the nits and the lice out, it’s painstaking and slow. It might take a half an hour, it might take an hour depending on the length of your child’s hair. There are other companies that are available to use. Which one do you like?

JB: Yeah, so there’s a few of them. The most interesting one goes under the name of Hair Fairies, and there’s a couple of other ones called Lice Enders and Lice Busters. These are companies that have their own proprietary products that they claim are effective for removing lice.

SR: They also claim they’re all natural, and they probably are. It’s difficult to really know what the ingredients are. Lice Busters, I believe, did give me their contents, their ingredient list, and it did seem that they basically use a conditioner, a hair conditioner, and comb, and comb, and comb, which is a safe, painfully slow process but seems to work fine for a lot of parents today.

So, if you’re children come home with lice, if you find you get lice from sharing helmets or hats or from whatever reason, you have many, many options. Most of them are safe, but remember to mix it up. Don’t use the same products multiple times in a row. Anything else?

JB: Nope, I think you did a great job.

SR: Welcome back to school and life. Bye.