Question: I like to eat out at restaurants, but often I get stomach cramps about an hour after eating salad, especially if it is from a salad bar. I must rush to a bathroom to avoid an embarrassing incident of diarrhea.
I feel sure there must be some substance, perhaps a preservative on the lettuce or in the dressing, causing this reaction. I know other people who've had similar experiences, but I've never seen it addressed in your column. Do you know what it could be? I might be able to ask in advance whether the restaurant uses the substance and save myself distress.
Answer: What you are describing sounds suspiciously like a reaction to the preservative sulfite. Years ago, lettuce and raw vegetables at salad bars were dipped in a sulfite solution to keep them from turning brown. This is no longer legal because the Food and Drug Administration banned the use of sulfites on fresh fruits and vegetables in 1986. Too many people had experienced hives, diarrhea or life-threatening asthma attacks when exposed to these chemicals.
Salad bar lettuce should be safe, but other salad ingredients, such as shrimp, might cause trouble. Some salad dressings contain sulfites, and so do dried fruits like apricots or golden raisins. Beware of foods such as hash browns, home fries, jam, molasses, soup mixes, canned vegetables, wine and flaked coconut.
Question: I've had to resort to taking Tylenol PM to sleep because my doctor will not renew my prescription for Ambien. It worked like a charm, but he says I should not rely on it every night.
What are the consequences of taking Tylenol PM every night? My other medications are metoprolol to control blood pressure and Wellbutrin to help me stop smoking.
Answer: In these anxious times, a lot of people are having trouble sleeping. Medications can also cause problems. Beta blockers like propranolol (Inderal) and metoprolol (Toprol, Lopressor) can trigger nightmares and insomnia. Bupropion (Wellbutrin) can also affect sleep quality. Ask your doctor if there are alternatives.
We are sending you our Guide to Getting a Good Night's Sleep, which lists medications that can cause insomnia and discusses a number of nondrug solutions to this problem. Anyone who would like a copy, please send $2 in check or money order with a long (No. 10), stamped, self-addressed envelope to: Graedons' People's Pharmacy, No. I-70, P.O. Box 52027, Durham, NC 27717-2027.
Ambien can be very effective for insomnia, but in rare cases it might lead to dependence. Diphenhydramine (DPH) is a sedating antihistamine found in Tylenol PM, Excedrin PM, Nytol QuickCaps and many other over-the-counter sleep aids. Repeated use might lead to reduced effectiveness. Some people report feeling sluggish in the morning after taking DPH.
Question: I was interested to read about a side effect of the pain reliever Celebrex. I too experienced extreme breast tenderness. My blood pressure also shot up to 190/100. I was taking Vioxx instead of Celebrex, but I thought you might like to know about this.
Answer: Some people taking Vioxx do develop hypertension as a side effect. It is wise to monitor blood pressure when you take this drug.
In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of King Features Syndicate, 888 Seventh Ave., New York, NY 10019, or e-mail them at pharmacy@mindspring.com or via their Web site: www.peoplespharmacy.org. Their newest book is "The People's Pharmacy Guide to Home and Herbal Remedies" (St. Martin's Press). © King Features Syndicate Inc.