I realize I really should have edited down that last entry, because it was hilarious, but its size was intimidating (remind you of anyone you know? Yes...it's me). Here are the best bits:
First, the very best -
If you take too much Aclin, you may feel dizzy, light-headed and have a decreased urine output. You may also become unconscious.
Now the rest:
There is no evidence that Aclin is addictive.
Do not take Aclin if:
- you are vomiting blood or material that looks like coffee grounds
- you are bleeding from the back passage, have black sticky bowel motions (stools) or bloody diarrhoea.
Do not take Aclin if you are pregnant or intend to become pregnant.
Aclin may affect your developing baby if you take it during pregnancy.
Do not take Aclin if you are breastfeeding or plan to breastfeed.
Do not give Aclin to children.
Take Aclin during or immediately after food.
Depending on your condition, you may need Aclin for a few days, a few weeks or for longer periods.
Roxanne's doing great, if you're here for info on her. She's seriously cuter every day, and should be reaching critical cuteness mass around the six month mark. Make your peace.
This leaflet answers some common questions about Aclin.
It does not contain all of the available information. It does not take the place of talking to your doctor or pharmacist.
All medicines have benefits and risks. Your doctor has weighed the risks of you taking Aclin against the benefits they expect it will have for you.
If you have any concerns about taking this medicine, talk to your doctor or pharmacist.
Keep this leaflet with your medicine. You may need to read it again.
What Aclin is used for
Aclin relieves pain and reduces inflammation (swelling, redness and soreness) that may occur in the following conditions:
• various types of arthritis including osteoarthritis, rheumatoid arthritis, ankylosing spondylitis and acute gouty arthritis
• muscle and bone injuries such as sprains, strains, lower back pain and tendonitis (e.g. tennis elbow).
Aclin belongs to a group of medicines called Non-Steroidal Anti-Inflammatory Drugs (NSAIDs).
Your doctor may have prescribed Aclin for another reason. Ask your doctor if you have any questions about why Aclin has been prescribed for you.
Aclin is available only with a doctor's prescription.
There is no evidence that Aclin is addictive.
Before you take Aclin
When you must not take it
Do not take Aclin if you are allergic to medicines containing sulindac, aspirin, any other NSAID or any of the ingredients listed at the end of this leaflet.
Some of the symptoms of an allergic reaction may include skin rash, itching or hives, swelling of the face, lips or tongue which may cause difficulty in swallowing or breathing, wheezing or shortness of breath.
If you are allergic to aspirin or NSAIDs and take Aclin, the above symptoms may be severe.
Many medicines used to treat headache, period pain and other aches and pain contain aspirin or NSAIDs. If you are not sure if you are taking any of these medicines, ask your pharmacist.
Do not take Aclin if:
• you are vomiting blood or material that looks like coffee grounds
• you are bleeding from the back passage, have black sticky bowel motions (stools) or bloody diarrhoea.
Do not take Aclin if you are pregnant or intend to become pregnant.
Aclin may affect your developing baby if you take it during pregnancy.
Do not take Aclin if you are breastfeeding or plan to breastfeed.
The safety of Aclin in breastfeeding has not been established.
Do not take Aclin if the expiry date (Exp.) printed on the pack has passed.
Do not take Aclin if the packaging shows signs of tampering or the tablets do not look quite right.
Do not give Aclin to children.
Before you start to take it
Tell your doctor if you have allergies to:
• any other medicines including aspirin or other NSAIDs
• any other substances, such as foods, preservatives or dyes.
Tell your doctor if you have, or have had, any medical conditions, especially the following:
• heartburn, indigestion, stomach ulcer or other stomach problems
• vomiting blood or bleeding from the back passage
• kidney or liver problems
• diabetes mellitus or sugar diabetes
• high blood pressure or heart disease
• a tendency to bleed or other blood problems
• are undergoing a surgery
• asthma.
Your doctor may want to take special care if you have any of these conditions.
Tell your doctor if you currently have an infection.
If you take Aclin while you have an infection, the tablets may hide some of the signs of an infection. This may make you think, mistakenly, that you are better or that it is not serious.
If you have not told your doctor about any of the above, tell them before you start taking Aclin.
Taking other medicines
Tell your doctor if you are taking any other medicines, including any that you buy without a prescription from a pharmacy, supermarket or health food shop.
Some medicines may be affected by Aclin, or may affect how well it works. These include:
• aspirin, salicylates or other NSAIDs
• warfarin, a medicine used to prevent blood clots
• tablets used to treat diabetes
• methotrexate, a medicine used to treat arthritis and some cancers
• DMSO (dimethyl sulfoxide), another medicine used to treat arthritis
• cyclosporin, a medicine used to suppress the immune system.
These medicines may be affected by Aclin, or may affect how well it works. You may need to take different amounts of your medicine, or you may need to take different medicines. Your doctor will advise you.
If you are not sure whether you are taking any of these medicines, check with your doctor or pharmacist.
Your doctor and pharmacist have more information on medicines to be careful with or avoid while taking Aclin.
How to take Aclin
How much to take
The usual dose is 400 mg per day, taken as a single dose or twice a day.
Your doctor may advise you to take a different dose. This depends on your condition and whether or not you are taking any other medicines.
Follow all directions given to you by your doctor and pharmacist carefully.
How to take Aclin
Swallow the tablets with a full glass of water.
When to take Aclin
Take Aclin during or immediately after food.
This will lessen the chance of a stomach upset.
If you take Aclin once a day, take the tablets in the evening.
If you forget to take Aclin
If it is almost time for your next dose, skip the dose you missed and take your next dose when you are meant to.
Otherwise, take the missed dose as soon as you remember, and then go back to taking your tablets as you would normally.
Do not take a double dose to make up for the dose you missed.
If you are not sure what to do, ask your doctor or pharmacist.
If you have any questions about this, check with your doctor or pharmacist.
How long to take Aclin for
Keep taking Aclin for as long as your doctor recommends.
Depending on your condition, you may need Aclin for a few days, a few weeks or for longer periods.
As with other NSAIDs, if you are using Aclin for arthritis it will not cure your condition but it should help control pain, swelling and stiffness. If you have arthritis Aclin should be taken every day for as long as your doctor prescribes.
For sprains and strains, Aclin is usually only needed for a few days.
If you are not sure how long to take your tablets, talk to your doctor.
If you take too much Aclin (overdose)
Immediately telephone your doctor, or the Poisons Information Centre (telephone 13 11 26), or go to Accident and Emergency at the nearest hospital, if you think you or anyone else may have taken too much Aclin. Do this even if there are no signs of discomfort or poisoning.
You may need urgent medical attention.
If you take too much Aclin, you may feel dizzy, light-headed and have a decreased urine output. You may also become unconscious.
While you are taking Aclin
Things you must do
Before starting any new medicine, tell your doctor or pharmacist that you are taking Aclin.
Tell all the doctors, dentists and pharmacists who are treating you that you are taking Aclin.
If you become pregnant while taking Aclin, tell your doctor.
If you plan to have surgery, including dental surgery, tell your doctor or dentist that you are taking Aclin.
If you get an infection while taking Aclin, tell your doctor.
Aclin may hide some of the signs of an infection and may make you think, mistakenly, that you are better or that it is less serious than it might be. Signs of an infection include fever, pain, swelling or redness.
Visit your doctor regularly so they can check on your progress.
Things you must not do
Do not use Aclin to treat any other conditions unless your doctor tells you to.
Do not give Aclin to anyone else, even if they have the same condition as you.
Things to be careful of
Be careful driving or operating machinery until you know how Aclin affects you.
Aclin may cause dizziness, lightheadedness or blurred vision in some people. If any of these occur, do not drive, operate machinery or do anything else that could be dangerous. If you drink alcohol, dizziness or light-headedness may be worse.
Things that would be helpful for your arthritis
Some self help measures suggested below may help your condition.
Talk to your doctor, physiotherapist, or pharmacist about these measures and for more information.
• Weight - your doctor may suggest losing some weight to reduce the stress on your joints.
• Exercise - may be recommended by your doctor or physiotherapist to help keep or improve movement and strengthen muscles. Ask a physiotherapist for an exercise plan suited to your condition. As a general rule if any exercise hurts then do not do it.
• Rest - is important and is usually balanced with exercise and activity. Rest is needed when joints are hot, swollen or painful.
• Heat - hot showers or baths may help to ease the pain and relax the muscles that can become tense with arthritis. Your physiotherapist or doctor can prescribe other forms of heat treatment.
• Physical aids - are available to help with daily household tasks. For example, there are gadgets and aids to help turn on taps, remove screw tops, pick up objects and handles can be fitted in bathrooms. Ask your pharmacist or doctor to give you more information.
Side effects
Tell your doctor or pharmacist as soon as possible if you do not feel well while you are taking Aclin.
Aclin helps most people with arthritis, but it may have unwanted side effects in some people.
All medicines can have side effects. Sometimes they are serious, most of the time they are not. You may need medical treatment if you get some of the side effects.
If you are over 65 years of age, you may have an increased chance of getting side effects.
Do not be alarmed by this list of possible side effects.
You may not experience any of them.
Ask your doctor or pharmacist to answer any questions you may have.
Tell your doctor if you notice any of the following and they worry you:
• stomach upset including nausea (feeling sick), vomiting, heartburn, indigestion, cramps
• loss of appetite
• constipation, diarrhoea, pain in the stomach, wind
• dizziness
• headache
• buzzing or ringing in the ears
• nervousness
• swelling of the hands, feet, ankles.
These are the more common side effects of Aclin. They are usually mild and often respond to a reduction in dosage.
Some of the stomach upsets, such as nausea and heartburn, may be reduced by taking the tablets with food.
Tell your doctor immediately if you notice any of the following:
• severe pain or tenderness in the stomach
• eye problems such as blurred vision
• severe dizziness, spinning sensation
• change in mood, for example, depression
• tingling or numbness of the hands or feet
• fast or irregular heartbeats, also called palpitations
• difficulty hearing
• signs of frequent or worrying infections such as fever, severe chills, sore throat or mouth ulcers
• bleeding or bruising more easily than normal
• signs of anaemia, such as tiredness, being short of breath, and looking pale
• yellowing of the skin and eyes, also called jaundice
• a change in the colour of urine, blood in the urine
• a change in the amount or frequency of urine passed, burning feeling when passing urine
• symptoms of sunburn (such as redness, itching, swelling, blistering) which may occur more quickly than normal.
These are rare yet serious side effects. You may need urgent medical attention.
If any of the following happen, stop taking Aclin and tell your doctor immediately, or go to Accident and Emergency at the nearest hospital:
• vomiting blood or material that looks like coffee grounds
• bleeding from the back passage, black sticky bowel motions (stools) or bloody diarrhoea
• swelling of the face, lips or tongue which may cause difficulty in swallowing or breathing
• asthma, wheezing, shortness of breath
• sudden or severe itching, skin rash, hives
• fainting, seizures or fits
• pain or tightness in the chest.
These are serious side effects that need urgent medical attention or hospitalisation. These side effects are rare.
Other side effects not listed above may also occur in some patients. Tell your doctor if you notice anything that is making you feel unwell.
After taking Aclin
Storage
Keep Aclin where children cannot reach it.
A locked cupboard at least one-and-a-half metres above the ground is a good place to store medicines.
Keep your tablets in the bottle until it is time to take them.
If you take the tablets out of the bottle they may not keep well.
Keep your tablets in a cool dry place where the temperature stays below 30°C.
Do not store Aclin or any other medicine in the bathroom or near a sink.
Do not leave Aclin in the car or on window sills.
Heat and dampness can destroy some medicines.
Disposal
If your doctor tells you to stop taking Aclin, or your tablets have passed its expiry date, ask your pharmacist what to do with any that are left over.
http://www.appco.com.au/appguide/drug.asp?drug_id=00071103&t=cmi
Brooke's always right, of course. She really wanted to move to Vermont when we were first looking at houses. So there's this site called findyourspot.com that asks you 8 pages of questions and then tells you the ideal places you should live. Here are my top picks -
Burlington, Vermont
Northampton, MA
Woodstock, VT
Williamstown, MA
Danbury, CT
Essex, CT
Middlebury, VT
Johnson, VT
And so on. You have to go to spot # 22 (Gardnerville-Minden, Nevada) and #23 (Joseph, Oregon) to find a spot that's not in New England. Guess I'm just a natural-born Yankee.
Two columns for you today - one about Roxanne, and one that should be of special interest to the loyal Bigwhoopers. Check 'em out!
RING IN THE NEW, BABY
The biggest day of my life took me by complete surprise, but only because I didn't see the signs and portents that surrounded it. For instance, the night before it happened, we decided to eat at the Outback Steakhouse, slogan: No Rules, Just Right. Just over twelve hours later my first daughter was born, December 23rd, 2005, at 12:16 P.M. She was due in late January, but she managed to come four weeks early, tiny but perfectly healthy, and just in time for Christmas vacation so everyone could come see her and spend time with her. That's Roxanne Lillian Aclin...no rules, just right.
Of course, failing to see signs was practically my theme on Roxanne's birthday. The day began at 7 A.M., when Brooke woke up complaining about unbearable back pain. Being the caring husband and father-to-be that I was, I immediately went back to sleep. Brooke had bravely faced down all sorts of aches and pains during the pregnancy, so that was nothing new, but I was on vacation and I was determined to sleep in. Of course, a few minutes later it became clear that these were no ordinary pains, so we made an appointment to go see the doctor.
I want to be clear that at this point it was entirely outside my realm of possibility that Brooke might be in labor. In fact, my first thought once we pulled into the doctor's office, besides hoping Brooke was okay, was "Oh boy, maybe they'll have to do another sonogram!" So when the doctor examined Brooke and told us she was not only in labor but pretty far along, it took several seconds for my brain to catch up. All I could wonder was how the doctors could be so wrong. She’s having back pains, not a baby! Luckily, I overcame my stupefaction finally and packed us off in the car for the hospital.
During labor, I did my best to fulfill my paternal role, which was to act as Lamaze coach, helping to ease the pain of passing a small person out of your body through breathing techniques and focused relaxation. It worked about as well as it sounds like it might. I tried to count to four and tell Brooke to take deep, long breaths, but I was promptly told to "shut the ^$%# up." In fairness, Brooke also told her mother, my mother, the doctor and all the nurses the same thing, so it wasn’t just me. In further fairness, if someone were trying to get me to count in a similar circumstance, I’d probably tell him to do far worse things than shut up.
Roxanne was born and then quickly spirited away for observation because she was so small (5 pounds 7 ounces at birth). She came out screaming so we knew her lungs were okay, and when the doctors were convinced everything was copasetic they gave her to us to take home on Christmas Day/First Night of Chanukah Day. I knew once we got her home it would be a lot of hard work. I knew there'd be a lot of sleepless nights...why do you think I was so determined to sleep in the day she was born? But nobody warned me I’d be so scared all the time. To think that such a perfect little human being was created by the two of us out of nothing...well, how could everything be running so smoothly? I have a hard enough time making a quiche, and quiche doesn’t have a central nervous system.
It’s still so weird to me. Not only that this baby who has my toes is the same baby I felt kicking me through my wife’s stomach just a week ago, but the fact that, as much as you feel like your baby is the center of the universe and the whole world has grinded to a halt around her, so many people are doing this every day of the week. Millions of little universe-centers, all keeping their parents up all night. So the next time you're eating at an Australian-themed steakhouse, think of me and my little holiday surprise. I don’t care what the slogan says...parenthood rules. And that's just right.
And the next one...
A TALE OF TWO LOCAL BOYS
Hard to believe, but it was a year ago this week that this column started up and I first told my tale of coming back to Goshen. For those of you late to the party, in a nutshell: I went away to college, I moved back, got a job a non-insane commuting distance away, married my high school sweetheart, bought my childhood home from my mom and, shortly thereafter, had a future student in the Goshen school system. Picture that, but with a lot more smarm and parenthetical asides and it was basically that first column from a year ago.
But for every local boy like myself, there are dozens of local boys and girls who leave Goshen and never end up coming back. In fact, I virtually never run into people I went to high school with around town. So what becomes of them? What makes them choose to settle outside their hometown? To get to the bottom of things, I decided to interview one of these local boys gone non-local to find out how he got to where he is.
Matt Jankowski comes from one of the largest families in Goshen and surrounding areas. I don’t know how it is now, but when I was in school here there were a lotta Jankowskis. He and I both graduated Goshen High School in 1998, both attended college in Massachusetts, and both (though at differing times -- Matt had initially taken a job in his college town of Worcester) ended up briefly moving back in with our parents in Goshen after college graduation. And that’s where our paths diverged. While I found employment in nearby (and scenic!) Rockland County, Matt told me that after moving back to Goshen, "I almost immediately found a job in Manhattan and didn't want to deal with that commute, so I moved to Westchester." A few moves later and he found himself living in the city itself, rooming with a bunch of our former Goshen classmates.
So Matt ended up leaving Goshen not out of a burning need to escape but out of convenience. On the other hand, Matt doesn't see himself moving back to Goshen in the near future, either. "For both professional and personal purposes," he said, "I don't think it would work right now." Since so many people I know who find themselves living in New York City tend to get very passionate about it, I expected Matt to tell me he would never come back to the provincial life of Goshen. After all, he’d seen the bright lights of Manhattan -- the brightest lights in Goshen are on 17 when they're doing bridge construction at night. In fact, that was kind of the narrative I was planning on telling -- the big bad city steals our young people away with its jobs and its cultures and then never lets them go. Unfortunately for my narrative Matt's answer took me by surprise, which is why I usually just write these things out of my own head -- I rarely disagree with myself.
"I do spend time on holidays and other times that I'm home considering the advantages and disadvantages -- not necessarily of Goshen in particular -- but of the city vs. suburb worlds," Matt said. "I think that I'll end up settling down in a Goshen-like city, but Goshen itself would almost be an odd coincidence. I like the particular circumstance of simultaneous access to and separation from a big city that Orange County has. That's why I call it 'The Real OC.'"
So it's not a deep-seated hatred of small-town life that keeps people like Matt from returning to Goshen. As he pointed out, "I think that a lot of where people end up is...not necessarily accidental, but not truly planned. Almost all of my college friends that I'm still in touch with on a regular basis are either engaged, about to be engaged, having children, buying houses, etc. And most of them live about 20-30 minutes outside of Boston. On a trip up there a few weeks ago it occurred to me that if that job had went as planned, I'd probably be up there, buying a house, and possibly engaged. This was kind of disturbing at first, but now I'm pretty comfortable with it, because I think if anything it's just revealed to me that there are many, many different ways that people can go about things and still wind up happy."
And, in talking to Matt I realized something as well. I didn't end up back in Goshen by some grand scheme wherein I had always planned to come back to my hometown and set up a dynasty of Goshen Aclins. Like Matt's college friends and Matt himself, I was blown about by the winds of chance and circumstance. If I had gotten a really great job in Los Angeles or New York right out of college I'd probably be there right now, still married but certainly not a homeowner and quite possibly not yet a parent.
So...thanks, winds of chance and circumstance!