Ask the Doctor: Hydrocodone; Hearing Aids; Sustained Weight Loss

Q: I’m going to have knee surgery, and I’m concerned about the painkillers I may be prescribed afterwards. I’ve read how hydrocodone can be addictive. Any thoughts?

A: Hydrocodone is among a class of drugs known as narcotic analgesics. It’s also an opioid, which means it binds to opioid receptors in the brain, spinal cord and gastrointestinal tract. Hydrocodone, which is the key ingredient in the widely used prescription painkiller Vicodin, interferes with pain signals to the brain. In addition to reducing pain, hydrocodone can also create feelings of euphoria, as well as drowsiness.

When used properly and in the short term, hydrocodone can be a safe and effective painkiller. But you’re right that it can become habit-forming. The longer patients use hydrocodone, the higher dosage they may need to achieve the same effect. Hydrocodone is among the most highly abused opioids in the U.S. Abusers may start seeing multiple doctors to obtain several prescriptions. Personality changes stemming from hydrocodone abuse can interfere with jobs and relationships.

If you are concerned about the potential risks associated with hydrocodone, talk with your doctor about alternative painkillers. Remember also that using hydrocodone for a brief time won’t automatically lead to addiction.

Q: I have to get a hearing aid, but I’m concerned about the long-term costs. How often do hearing aids need to be replaced or serviced?

A: The average hearing aid lasts about five to seven years, but technological breakthroughs are extending the lives of these devices. In some cases, changes in your hearing may determine the time you need to get a new hearing aid. Some devices can be programmed to accommodate hearing loss progression. You should talk with your doctor about whether you should try to get a device that can be adjusted as needed.

Other people may simply outlive their hearing aids, and require new ones. There is no way to accurately predict how long a particular device will last. And unfortunately, Medicare doesn’t cover hearing aids, though that could change in the years ahead.

If finances are a concern, you may have some options. Medicaid, if you’re eligible, may be able to cover part of the costs of hearing aids. Veterans may also be eligible for hearing aids and other medical services that aren’t typically covered by Medicare. Local and state agencies may be able to help you find programs that allow you to pay on a sliding scale for hearing aids, or direct you to other programs that can help.

Q: I’m very proud to say I’ve lost more than 50 pounds in the past two years, and I did it without surgery or a fad diet. But I’m worried about keeping the weight off. Any suggestions?

A: First of all, congratulations on your weight loss. Losing two to three pounds a month is a safe goal and a very achievable one if you do so through a healthy diet and exercise.

Your concerns about gaining the weight back are valid. I do have a couple of suggestions. First, focus on how much better you feel at this weight. You probably have more energy. You may notice that your knees are feeling stronger, you sleep better and you can move more without feeling short of breath.

Also, if you’ve been able to sustain this steady weight loss for two years, you’re probably already making smart lifestyle decisions like eating smaller portions, exercising regularly and avoiding high-calorie, low-nutrient foods. You don’t need to do anything special to keep the weight off. Just continue to make smart choices. Weighing yourself daily may also help, because noticeable weight gain can prompt you to exercise a little more and skip desserts until you get back to your target weight. And if you’ve kept a food diary, continue to do so. It will let you see if you’re starting to make unhealthy choices.

—Editor-in-Chief Bruce A. Ferrell, MD

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