Ask the Doctor: aspirin, sprained or bruised hand and behavior medication

Dr. Rob Riley joins us each week from the South Bend Clinic. Here are his responses from July 23rd.

Vicky: I'm over 50 now. Should I be taking an aspirin every day for my health?

Aspirin interferes with normal clotting in the body. This may help to reduce one's risks for heart attacks and strokes. But we also know this affect can increase one's risk for serious bleeding, particularly bleeding in the stomach and intestines. So the challenge for science has been to figure out this balance between potential benefits and potential harms. Unfortunately, several studies published in the past year have shown the benefits to be less than we previously thought for most people. So the recommendations now are for people to be on daily aspirin only if they're at high risk for heart attacks and strokes, such as people who have had a heart attack in the past, for example. But this really needs to be individualized. So, talk to your doctor about your risk for these events as well as your risk for bleeding complications to arrive at the best answer for you.

Nicole: Yesterday I hurt my hand and heard a loud crack. I've been icing it and have a brace on. Could it be sprained or just badly bruised? It feels better today.

Well, yes, it could be sprained, bruised, or there could be a fracture. Ice and bracing could help it to feel better regardless of the cause, so our viewer's done a good job with initial management. But the fact that things seem better today doesn't rule out the possibility of a broken bone. It's particularly important to diagnose and properly treat injuries in the hands and wrists because we rely so heavily on their function in our daily lives. Hearing a crack associated with an injury is not typical of an injury that's just a bruise, so I think it's best for our viewer to get this checked out. Your doctor may recommend an x-ray to determine if anything's broken and to make sure you get the best care for this injury.

Bryana: Is it good to stop and start behavior medication on a normal basis—say don't take it one day but take it the next and so on?

It would really be helpful to know which particular medication our viewer is talking about here, but in general, most of the medications used for conditions like depression, anxiety, and attention deficit disorder are designed to be taken every single day. Most of these medications take some time to achieve their full effect, so taking them every day is important for that to happen. There are some medications for anxiety disorders that are designed to be taken as needed when people experience that symptom, but the science has shown us that that's not the most effective approach for most people with this condition so those medications are not used so much anymore. So, as always, the best approach is to stay in touch with your doctor and take any prescription medications exactly as they've been prescribed.