Question: Are sleeping pills harmful?
Most sleeping pills are very safe, provided they are taken in the recommended manner, but if used constantly for many weeks or months, patients may find it very difficult to stop them as they become dependent upon them. The greatest problem with the use of sleeping pills is that they are taken unnecessarily, particularly by elderly people who do not need large amounts of sleep. These pills are better taken intermittently when really needed, and they will work far more effectively.

Question: As a 77 year old, my doctor has suggested that I take 100 mg of aspirin every day to reduce my risk of having a stroke or heart attack, but I have had a stomach ulcer in the past and take Zantac every day. I was told that I should never take aspirin again because of my ulcer. What should I do?
Aspirin is a marvelous medication, and one of the oldest in current medical use, having being first marketed by a German chemist (Bayer) in 1899. It may be used to relieve pain, reduce inflammation (eg. in arthritic joints), decrease the risk of bowel cancer and reduce the ability of blood to clot.
This last use makes it suitable to reduce the risk of blood clots in the brain (stroke) or coronary arteries (heart attack), and as a result it is widely recommended by doctors to be taken regularly by all patients over 50. When used to relieve pain, aspirin is taken in doses of 600 mg (two tablets), four times a day, but when used to reduce blood clotting, only a very small dose of 75 to 100 mg a day is necessary, and strangely, higher doses may be less effective in reducing the risk of clots.
Aspirin also has side effects, most commonly resulting in stomach pain, and sometimes bleeding from the stomach, but this effect is dose dependent, and the higher the dose, the greater the risk of side effects. Low-dose aspirin is available in special formulations that reduce, but do not entirely eliminate, the risk of stomach side effects. These are marketed as Astrix, Cartia and Cardiprin, and are subsidised by the government for pensioners under the pharmaceutical benefits scheme.
It is possible that you will suffer stomach side effects from taking low dose aspirin long term, and if this occurs there is a substitute medication (Plavix), that is much more expensive than aspirin, but it does not have some of the added benefits of aspirin (eg. against bowel cancer). It is only subsidized by the government under very stringent conditions.

Question: I am concerned about using tampons after reading about the toxic shock syndrome. Is this a significant risk for women, or can I still use tampons safely?
The toxic shock syndrome, despite all the publicity, is actually a very rare condition, and most general practitioners have never seen a case. The people who do develop the condition are extremely ill, and about 5% of them die, despite the best efforts of doctors. Some bacteria, and particularly one called Staphylococcus aureus (the golden staph) which is a common cause of vaginal and other infections, may produce a toxin or poison. Most people have antibodies to protect them from this problem, but in a very small number of people, the toxin may cause severe effects.
The symptoms of toxic shock syndrome are a high fever, dizziness, severe diarrhea, vomiting, muscle aches, fainting and sometimes a rash. An examining doctor will find the blood pressure to be low. The syndrome can occur in anyone, but seems to be more common in women and particularly in women who are menstruating. Treatment involves antibiotics to treat the bacterial infection, and hospitalization to replace the fluids lost with the severe diarrhea and vomiting. There is no specific antidote to the toxin, and so the earlier the diagnosis is made, the better the chances of recovery.
There is no reason why women should not use tampons, as the risk of developing toxic shock syndrome with them is infinitesimally small. Only if the tampon becomes infected is there any chance of developing the syndrome. To reduce the risk to a minimum, ensure your hands are clean before unwrapping and inserting the tampon; use the lowest absorbency tampon necessary for your flow; never insert more than one tampon; do not leave the tampon in for any longer than necessary; and pads may be a better alternative overnight. Make sure you don’t forget to remove the last tampon of your period. There is no evidence that any one brand or type of tampon is more likely to cause the syndrome than any other.
Relax and use the menstrual hygiene product that best suits your needs.