Saturday, August 31, 2013

Summer sun safety: Contact lenses with UV protection

File this under melanoma awareness.  This isn't my column, but it is a great idea and something to share with others.

Summer sun safety: Contact lenses with UV protection

Published June 24, 2013

With the official arrival of summer, taking protective measures against the sun’s dangerous rays is essential. While many may think they’re prepared with sunscreen, a hat and sunglasses, doctors say there’s another must-have to add to the list: UV-blocking contact lenses.

Contact lenses with ultraviolet protection help reduce or eliminate the UV rays that would normally strike the naked eye, according to Dr. Karl Citek, professor of optometry at Pacific University College of Optometry, and member of the Foundation of the American Academy of Ophthalmology (FAAO).

While it’s common knowledge that UV rays can cause serious damage to the skin, many may not realize that they also pose major short and long term threats to eye health as well.

One of the most common effects is called photokeratitis – or a sunburn of the eye.

“It can be quite painful, with additional symptoms of itching or burning, a sandy or gritty feeling, and increased sensitivity to light,” Citek told in an email. “It usually resolves within 24 to 48 hours, even with no treatment, but it is still best to see an eye care professional who can provide artificial tears or lubricants as well as antibiotics to reduce the risk of a secondary infection.”

Additionally, UV rays can cause long term damage to the eye. Sun exposure can cause cataracts, resulting in a clouding of the lens inside the eye, which severely reduces vision and can only be corrected with surgery, Citek said. It can also cause conditions like pinguecula, a raised bump on the sclera – the white outer wall of the eye – or pterygium, an abnormal growth of tissue from the sclera onto the cornea.

“Both conditions exacerbate dry eye problems with symptoms of burning, itching, sandy/gritty feeling, etc., and can make wearing contact lenses uncomfortable or impossible,” Citek said. “In addition, if a pterygium grows beyond the center of the cornea, it will reduce vision; it can only be removed surgically, but it has a tendency to grow back.”

Furthermore, sun exposure can lead to cancer in the eyeball and can also exacerbate age-related macular degeneration (AMD), resulting in severe vision loss, according to Citek.

Not all lenses offer UV protection, but those that do typically include a label on the box, and patients can also consult with their doctors.

The lenses, which are regulated by the FDA, come in two categories of protection: Class I blockers, recommended for high-exposure environments like the beach, block more than 90 percent of UVA rays and 99 percent of UVB rays. Class II blockers, recommended for everyday conditions, block 70 percent of UVA rays and 95 percent of UVB rays.

“Currently three major soft contact lens manufacturers offer at least one line of product that offers UV protection: Vistakon, with all Acuvue lenses; CibaVision, with PrecisionUV lenses; and Bausch & Lomb, with BioTrue ONEday lenses,” Citek said.

Brands are continuing to improve their offerings.  ACUVUE® recently released the 1-DAY TruEye® Brand Contact which claims to block out more than 96 percent of UVA rays and 99 percent of UVB rays that reach the lens.

“I think this is the best kept secret in the eye care arena,” Dr. Susan Resnick, a member of FAAO, and a paid consultant for ACUVUE® Brand Contact Lenses, told

However, while it may be tempting for UV-blocking lens wearers to leave the shades at home – doctors say that isn’t wise.

“Contact lens protection is never a standalone entity – it still needs to be used in conjunction with sunglasses and a broad-rimmed hat,” Resnick said.

Read more:

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Wednesday, August 28, 2013

Claritin May Relieve Bone Pain Caused by Neulasta/Pegfilgrastim

Do you get horrible bone pain when they give you your Neulasta (Pegfilgrastim) shot and for a couple of days afterward? 

Many of you will get relief with Tylenol or Naproxen or a Non Steroidal Anti-inflammatory pill.

Lately there has been a lot of anecdotal reporting of patients getting relief by taking Claritin.  Yup, that's right.  THAT Claritin (allergy medication).  Here's a great article about it and an ongoing trial looking at this very question.   You don't have to be in a trial to take it, as you can get Claritin without a prescription right over the counter.  You may want to try it (with your doctor's permission of course) and see if it helps.   The trials are so we can legitimately see if it actually works (other than anecdotal evidence) with large numbers of patients. 

Check out this excellent article by oncology nurse Katherine Mitchell, APRN, AOCNP

Using Antihistamines for Neulasta-Induced Bone Pain
"In our medical careers, we have all been guilty of recommending a remedy for a patient’s ailment because it worked for a handful of other patients, or even for ourselves, and thus we think, “Why not try this?” We know, however, that good medical practice warrants evidence to enable sound judgment and advice.
Something you may have begun to notice in the outpatient oncology setting is the use of Claritin (Loratidine) for Neulasta (Pegfilgrastim) induced bony pain. Neulasta is used with certain chemotherapy regimens to lessen the incidence of chemotherapy-induced neutropenia, thus reducing the risk of infection. The drug works by stimulating the bone marrow to produce new granulocytes. This stimulation, or “revving up” as I like to describe it, of the bone marrow often leads to some degree of bone pain.
Our greatest marrow reserves are located in our pelvis and femur, and therefore pain is often reported in these regions, typically lasting for a few days after the Neulasta injection. There are, however, those patients who suffer from significant bone pain; so much so they will say it is worse than the chemotherapy. Traditionally we have tried NSAIDs, narcotics, or steroids. But these often fall short in controlling the pain. It is in these patients that we find ourselves needing to think outside the box -- this is where Claritin may come in handy.
Claritin is a tricyclic antihistamine, which acts as an inverse agonist on peripheral H1 histamine receptors. It is thought that perhaps in addition to the physiologic stimulation of the bone marrow, there may be inflammation and the release of histamine. Thus the use of an anti-histamine could potentially be helpful. I have seen this work for a handful of patients in clinical practice. We used it for those cases where we were out of other good ideas to help the patient, short of cutting out Neulasta all together.
Thankfully there are now clinical trials underway to investigate this remedy appropriately and finally help us as clinicians to come to a determination as to whether this is sound, evidenced-based advice we are giving out.
Currently has two trials, one of which will actually close this month. The other trial, which started in 2012, is still ongoing. Perhaps you are a research nurse, or have patients who might be good candidates for inclusion, assuming you live near one of the location sites.
I encourage you to check these out and, of course, be on the lookout for any data to come from these trials. I would also love your anecdotal experience; though again I realize reading your comments won’t necessarily help me make a good scientific decision."
Great article Katherine Mitchell!!!
Here is the trial that is currently open and accruing which looks at this very question.  The trial number:   Protocol IDs: 20110147, NCT01712009
This trial randomizes you (like a flip of the coin) to decide whether you will receive:
1)  Claritin
2)  Naproxen
3)  No Treatment
Hope this helps!
Update 5/4/2024: I am pretty sure that I read somewhere that Claritin or Benadryl made no real difference in bone pain in this clinical trial. But, some anecdotal evidence suggests that some people get relief from Claritin with Neulasta pain. Please discuss further with your MD!

Saturday, August 24, 2013

Sailing Heals

I have the very fabulous Shirley to thank for this great resource!!
Shirley is an awesome ovarian cancer survivor who loves the ocean.  She went on a day sail with the folks from "Sailing Heals".  According to Shirley, it was an amazing day!! 
Cancer survivors and their guests get a free sail (and sometimes lunch!) out on the ocean compliments of Sailing Heals and their generous donors.
According to their website, Sailing Heals is a non profit that teams sailors up with cancer survivors, (and their caregivers/friends) and provides them with a sailing experience that they will not forget!!
Apparently they can take groups ranging in size from 20  to 150 depending on the size of the boat.  The ride can last as long as a few hours on their day sail, to several days on one of their schooners.
This is a resource for cancer survivors in MA, RI, and FL.  WOW.  What a great idea and awesome gift for cancer survivors and their families!!!  The healing power of the ocean.  Spending time with caregivers and friends away from doctors and clinic appointments = AWESOME.

I also love that they call their cancer survivor guests simply "VIP guests"!!  So true!!
You can't really say it better than this...
"Cancer took a backseat that day; we had the time of our lives" -Linnea Duff, VIP guest of Sailing Heals.
From their website:
About Sailing Heals

"Sailing Heals’ essential mission is to take individuals and their families or caretakers out on the water for a beautiful day of sailing and respite. Sailing Heals matches owners of beautiful boats (sailing or motorized) with patients and their caretakers and host them for complimentary 2 hour sails, often accompanied by a water-side lunch or picnic. 
Sailing Heals is a 501(c)(3) organization which offers enjoyable sailing experiences to VIP patient guests, their caretakers and staff who would benefit from a memorable and healing day on the water. Operating in Marblehead, MA, Southeastern MA, Nantucket, New York City, Newport and Miami, its mission is to give people in need an “escape for a spirit-lifting day at sea.” Its second aim is to bring the great sport of sailing and the healing properties of the sea to people who might not ordinarily be exposed to its benefits; and its third aim is to be the charity of choice for sailing and boating enthusiasts who are keen to give back to others and share their beloved sport. Sailing Heals is supported by generous donors and sponsors."
To find out more information about becoming a donor or becoming a VIP cancer survivor guest, contact them at:
Sailing Heals, Inc.
5 Winchester St.
Bradford, MA 01835

Thanks for telling me about this great resource Shirley!!