DEAR DOCTOR. ROACH: I’m going to start a new job that will require regular but random drug tests. I’ve never used drugs before so that’s not a problem. But I wonder how long alcohol can be detected in the urine. – – MM
REPLY: Alcohol can be found in urine in small amounts while it is in the blood and shortly afterwards. These types of drug tests can be used to assess whether a person is consuming alcohol in the workplace.
However, some laboratories are looking for metabolic end products of alcohol metabolism such as ethyl glucuronide. These can be found in the urine for three days after heavy drinking. This type of test is done in a situation where people shouldn’t have alcohol, such as when B. in alcohol treatment programs, as part of legal proceedings or in transplant evaluation. These tests are not suitable for most job tests.
No test is perfect. A memorable case report several years ago identified a person with diabetes who had a positive alcohol test despite abstinence. He had yeast in his urine, which was producing the alcohol.
DEAR DOCTOR. ROACH: Many seniors struggle with balance. Are these problems usually more to do with physical strength or areas in the brain that are concerned with balance? – EM
REPLY: Imbalance disorders can result from a relative loss of physical strength, sensation, vision, and the balance organ in the inner ear. Often it is a combination of many, and treatment is often aimed at multiple areas. This includes strength and balance training, as well as treating vision problems and other conditions that could affect the nervous system.
While physical therapists and occupational therapists can be helpful for people with serious problems, just doing simple balance exercises can be helpful. Tai Chi is a discipline that has been shown to improve strength, balance and reduce falls. My colleagues at the Mayo Clinic put together a slideshow of some simple balance exercises here: tinyurl.com/Mayo-balance.
DEAR DOCTOR. ROACH: I am 73 years old, female and in very good health. I weigh 113 pounds and am 5 feet 4 inches tall. I don’t take any medication. I recently had blood tests for cholesterol levels. My total cholesterol is 230, HDL 80, LDL 135, triglycerides 48. I exercise regularly and still work out.
My doctor is concerned that my cholesterol is too high. She mentioned that I was taking cholesterol lowering drugs that I am against. I would like your opinion on whether it affects my cholesterol levels. My blood pressure is normal and I have never smoked. – NT
REPLY: I don’t think statins are cholesterol-lowering (although they are). Rather, they are medicines used to reduce the risk of heart attack and stroke. An online calculator (tools.acc.org/ASCVD-Risk-Estimator-Plus) estimates the risk of a heart event in the next 10 years at 11.6%. Taking any medication is expected to lower your risk to around 9.6%. In other words, 50 people like you would need 10 years of treatment to prevent a heart attack, stroke, or death from heart disease.
The fact that you exercise regularly is a good sign.
DR.ROACH WRITES: A recent column on over-the-counter drug dosing used aspirin as an example of dosing by weight and age. One pediatric nurse wrote with concern that aspirin should be avoided in children under the age of 16 due to the risk of Reye’s syndrome. I would add that the risk of Reye’s syndrome is highest in children and adolescents with influenza or chickenpox. I recommend against aspirin for children, except as directed by the pediatrician.
