The All-New Bunrab

Oh yeah, an addendum to the grapefruit juice. While one possible side effect is that your drug doesn't get digested properly at all, the other possible effect, depending on the drug, is that too much of it remains in your bloodstream, instead of getting eliminated (the liver bone's connected to the kidney bone) and so you can have the effect of an increased dosage - more chance of side effects, or of overdosage. Since it's too much trouble to detail the exact list of which drugs grapefruit juice renders too concentrated in the bloodstream and which ones it renders partly useless, let's just keep that rule of thumb in mind - avoid grapefruit juice within 2 hours of your pills, or at all if you're taking time-release medicines.

I have a couple of different bits of medical alert jewelry. Most medical alert bracelets are mildly ugly; some are heavy chain and quite ugly. While one wants a medical alert bracelet to catch attention when needed, I personally don't want to have it always catching attention for its sheer ugliness. I ordered several different kinds of bracelets, charms, and a necklace, right after I got my ICD/pacemaker. One kind of charm allows you to put a great deal of wordage on it; I got two of them, listing not only my condition and the existence of the ICD/PM, but also the names of all the medications I take.

One of the reasons so much of this jewelry is made of metal is that it's strong; if you are in a vicious accident of some sort, and thrown from a vehicle, your bracelet should stay on; if you are in a fire, your bracelet should last through the heat and flames. Well, I suspect that if I'm in that kind of a fire, my medical alert bracelet will be the least of my worries. I want something that's reasonably strong, won't rust or tarnish, won't weigh a ton - so materials other than metal chain were something I wanted to try.

So I decided to string beads on various things and see what works for bracelets. There are several different kinds of medical alert tags/charms/plaques/bars/things-that-fasten-on-to-other-things. I have two of the lightweight charms, cheap thin base metal on one side and detailed teensy engraved plastic on the other, one smooth stainless steel thing made to slide on a strap somewhat the size and width of a watch strap (the strap it came with is cheap vinyl imitating snakeskin only in blue, fastened with way too much velcro which irritates the wrist), and one standard bracelet - heavy silver-plated chain, alert tag with a hole in each end, attached into middle of chain, and hard-to-manage fastener. (I suspect the cheap base metal and the plastic engraved disk would get destroyed or melted in an accident or a fire as easily as many other materials; they don't offer the same sort of invulnerability that stainless steel, silver, or gold does.)

So I tried crocheting with lamé filament, which works pretty well; I strung a whole bunch of brown-toned glass beads of various sizes and included a bead in almost every stitch, and stuck one of the little alert charms in there as just another bead. But there has to be some kind of fastener; I crocheted a little bit of gold colored elastic cord between the two ends. So it stretches a bit to get over my hand, and is still a bit loose on my wrist, but not quite loose enough to fall off. I don't like really loose bracelets; anything that might get caught on part of the bike isn't a good idea in my opinion. Then I thought I'd try perle cotton, because it's softer than lame filament but still fairly strong; I did the same thing with beads and an alert charm. Had to do the same thing with the elastic to make it not so loose it would slip off. The perle cotton is soft, but it doesn't look as jewelry-like as the filament does. I also tried making a small bracelet without a tag, out of some leftover overdyed 6-strand cotton floss; that's strong, and the variegations in it look better than the solid color perle cotton - with glass beads, it has quite a hippie look to it. I imagine hemp cord would be similar; I may try that. Hemp is supposed to be quite strong.

I wanted to crochet using the elastic cord as my yarn, but it's too heavy to string beads onto. And I tried making a loop of some heavy cord, and crocheting some crochet cotton around the loop; however, it's nearly impossible to make the ends of the loop of elastic stay together when pulled, and it IS impossible to keep the fabric cover of the cord from fraying and sticking out between the beads and stuff. So I pulled that experiment apart again, to re-use the beads. Maybe with special equipment I could do a really good crimp on the ends of the elastic; I am going to ask a friend who builds rabbit cages if I can borrow a few J-clips and her J-clip squeezer, and see if that would serve as a good crimp.

So far, I like the filament one best, and a friend admired it.

More experiments to come. I want to find a cheap source for the alert charms; they don't have to have nearly as much verbiage on them as I have on mine, and many people just get them saying "see wallet card." I might try making a few bracelets with that kind of generic tag and see if anyone might buy them.

Some other things I'm going to try: linen-cotton blend ribbon yarn (linen is quite strong); leather cord. I might look for finer elastic, that I could string beads on, but then it wouldn't be very strong. I tried some rayon/metallic yarn, but I knew even before I started that even though the rayon was quite comfortable, it wasn't strong enough; rayon frays quite easily, and that sucker will probably abrade and fall apart after only a few dozen wearings, so I'll have to keep an eye on it and take it apart and make something else before that happens. I want to look for more waterproof ideas, too; the stainless steel tag will resist a lot of water, and if I can find a bracelet material that also will, that would be cool. The various threads mentioned above might not mind water per se, but they do object to the chlorine in most swimming pools; if nothing else, the color would fade after only a few dunks in Little Stacy Pool.

Recent medical articles point out that it is best to take your diuretics WITHOUT food, if you are taking a loop diuretic ("water pill"). The loop diuretics include furosemide (Lasix), bumetanide, torsemide, and ethacrynic acid. Food is known to alter the absorption of a number of drugs and significantly affect the rate at which people respond to the drugs. In the case of loop diuretics, even the PDR doesn't mention this. One study of Lasix showed that the drug reached twice the concentration in the bloodstream if taken while "fasting" than if taken with food. Fasting, in this sense, means no food for about two hours either before or after the pills are taken. Thus, if you take yours first thing in the morning, you should not eat breakfast until two hours later. If you eat breakfast first, then you should wait 2 hours before taking the diuretic, and then wait at least another 2 hours before eating lunch. Another study showed that the diuretic works best if taken before a meal, not after - so your best bet is to take your diuretic the minute you wake up, then do all your morning showering and exercise and stuff, then eat breakfast.

If you're like me, the furosemide (Lasix) takes about an hour and a half to kick in, and then I have to use the bathroom urgently. Since that's an hour and a half, a good rule of thumb is, after that initial pee (pardon the technical term), wait a few more minutes and then start making breakfast, and you'll be close enough to two hours for government work.

Of course you know that in general, you shouldn't take drugs with grapefruit juice. While there are some drugs that are not affected by grapefruit juice, so many of them are that you should just make it a rule. The same 2-hour limit works well - don't drink grapefruit juice within 2 hours before or two hours after taking any of your medications. With some drugs, particularly those designed to have a time-release effect, you shouldn't drink grapefruit juice at all. Time release capsules are like you are continuously taking the drug, so it's always within two hours of taking it. Your doctor and your pharmacist should give you this advice, but even if they don't, it's not a bad idea to just remember it yourself.
So here's your list:

If you are taking a drug that has SR, XL, TR, or other time release letters in its name, don't drink grapefruit juice at all.

If you are taking any prescription medication at all, then don't drink grapefruit juice within 2 hours before or after taking your drugs.

Of course, you can always ask your doctor and your pharmacist specifically about grapefruit juice - if they both say it's OK to drink it, then it's OK. But if you don't remember to ask, then use the above guidelines.