Dear Dr. Roach: I get all of my medicine by mail. Since the manufacturers stress keeping the pills at cool room temperatures, I wonder what the excessive heat does to them.
The medicine must cook all day in the mailbox — way over 100 degrees here in Florida. I wonder how much the pills or liquids are deteriorating, and how the effectiveness is influenced.
Dear F.N.: You are right to be concerned. All medicines should be stored in a cool and dark place, as direct sunlight and heat can damage their effectiveness.
Hormones, such as oral contraceptive pills, thyroid hormone and insulin, are among the most sensitive. Nitroglycerine is, as well. Although some are shipped in packaging with cold packs and insulation, that’s not always the case.
I recommend using a local pharmacy, but many people have prescription plans that require them to use mail order. If that’s the case for you, try to make sure the medicine will be delivered when you are available to receive it.
If you have a temperature-sensitive medicine, such as the ones I mention above (ask your pharmacist about others), ask your mail-order pharmacy to send it in special packaging during warm-weather months.
Dear Dr. Roach: My 59-year-old son has cirrhosis, probably from a blood transfusion he had as a teenager. His gastroenterologist tells him he is two years away from going on the transplant list for a new liver.
Do you know if someone with compatible blood could donate a piece of his or her liver? Would that provide him with enough healthy liver?
Also, he heard that you live only about five years with a new liver.
Is that true?
Dear B.M.: Cirrhosis after a blood transfusion makes me suspect that your son’s liver disease is due to hepatitis C. If that’s the case, his gastroenterologist has had or will have a discussion with him about new treatments for hepatitis C that will hopefully keep him from needing a transplant.
However, if he does need a transplant, it can be done from a family member or even from a nonrelated person. There are risks to the donor, but major complications happen in only 1 to 3 percent of cases. The transplanted lobe of the liver does rapidly regenerate. The results for the recipient are comparable to that of deceased organ donors. Only the transplant surgeons can recommend whether a living donor is possible.
For adults in your son’s age group, the likelihood of surviving five years after liver transplantation is about 70 percent.
Email questions to ToYourGoodHealth@med.cornell.edu.