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How dangerous are NSAIDs in patients with AF?

One of the most commonly asked questions in the office is the treatment of arthritis pain. This comes up because of the concern over taking NSAIDs (non steroidal anti-inflammatory drugs) in patients who are on anticoagulants (such as warfarin, or dabigatran, rivaroxaban, apixaban). My views on this matter have changed. But first, I want to… Continue reading How dangerous are NSAIDs in patients with AF?

NSAIDs — Yet another dubious “health” product at CVS

Now that the ‘healthiness’ of products sold at CVS stores is a matter of public discourse, it seems a perfect time to mention the common pain relievers known as Non-Steroidal Anti-inflammatory Drugs (NSAIDs). It just so happens that two FDA advisory committees are meeting today and tomorrow to discuss the cardiovascular risks of NSAIDs. The… Continue reading NSAIDs — Yet another dubious “health” product at CVS

Could NSAIDs actually cause inflammation?

This one is for you exercisers out there. You know me; I love to write about dogma-busters. I’ve got a good one for you tonight. For endurance exercisers, runners and cyclists alike, few myths have been more persistent. Imagine: We actually think taking non-steroidal anti-inflammatory drugs (NSAIDs) before exercise improves performance and relieves post-effort soreness.… Continue reading Could NSAIDs actually cause inflammation?

Cycling Wed: NSAIDs and Atrial Fibrillation: Part 2

Reports documenting the dangers of Non-Steroidal-Anti-Inflammatory Drugs (NSAIDs) continue to generate headlines. It’s a steady stream of bad news for patients who take these widely-available pain relievers. Sorry about the repetition folks, but it’s hard to ignore my daily email updates from the American College of Cardiology when they so directly pertain to endurance athletes.… Continue reading Cycling Wed: NSAIDs and Atrial Fibrillation: Part 2

CW: More on the dangers of NSAIDs

Your knee hurts. Your back aches. Your muscles are soooo sore the day after trying that new exercise. I get this; I race bikes. Yet I urge you to avoid seeking relief in the form of the pain-relievers called Non-Steroidal-Anti-Inflammatory Drugs, or NSAIDs. You have heard the names before: ibuprofen (Advil), naprosyn (Aleve), diclofenac (Voltaren),… Continue reading CW: More on the dangers of NSAIDs

Atrial Fibrillation and NSAIDs

Sunday nights in Autumn means one thing for this doctor-cyclocross racer: aches and pains.  Tonight, just as the thought popped into my head: “a few Alleve(s) probably wouldn’t fire up that reflux very much,”  I hear from the computer room… “Hey John, how much alleve were you taking when you had your AF,” asked my… Continue reading Atrial Fibrillation and NSAIDs

The simple reason the medical-home study failed…

This week, the Journal of the American Medical Association (JAMA) published a comprehensive study that has major health implications. Major because the negative findings should change how Americans think about health and healthcare. Plus, the findings validate a belief this doctor holds as truth. First my belief, then the study. One blog is enough for… Continue reading The simple reason the medical-home study failed…

In the treatment of pain, OPIOID helps caregivers weather the regulatory storm

What follows is a guest post. James Patrick Murphy, MD, MMM is board-certified in Pain, Addiction, and Anesthesiology. He is President of The Greater Louisville Medical Society and the Course Director for OPIOID — Optimal Prescribing Is Our Inherent Duty. Dr Murphy, a friend, writes on the matter of optimal prescribing of pain therapy. It’s… Continue reading In the treatment of pain, OPIOID helps caregivers weather the regulatory storm

Think twice before getting an injection for low back pain or sciatica

It’s been a while since I did a Cycling Wednesday topic. As I was skimming thorough the Journal of the American Medical Association last night, I came across this review article on spinal injection therapy for low back pain. It was a shocker. Two factors brought my attention to the article: First, almost all the… Continue reading Think twice before getting an injection for low back pain or sciatica

Notes from ACC — Day 3 (Final Day)

Sorry this took most of the week to get out. (There was a good reason.) Better late than never I suppose. On Day 3 of the 2013 American College of Cardiology meeting, I woke up well rested and inspired to squeeze in as much learning as possible. The first order of business was putting the… Continue reading Notes from ACC — Day 3 (Final Day)

Pradaxa is not a bad drug…

There was good news today in the atrial fibrillation world. Though no surprise to heart rhythm doctors, an FDA investigation reveals no evidence that new cases of bleeding are any higher with dabigatran (Pradaxa) than with warfarin. The full statement from the FDA is here. The assessment was undertaken because after approval of the novel… Continue reading Pradaxa is not a bad drug…