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Pain relief pills can aid with sleep ASK DR. H. Mitchell Hecht

Q: Can you explain why whenever I take Advil or Tylenol at bedtime I fall asleep so much faster and sleep so much better? They’re not sleeping pills, but to me, they sure act like they are.

A: While Advil and Tylenol aren’t sleeping pills or tranquilizers, they definitely do help many people sleep better. That’s because many of us have aches and pains that annoy us at night — especially as we toss and turn in our sleep. Rolling onto your bad hip or turning into a position that aggravates your chronic low back pain will briefly disrupt sleep to cause awakenings in the night that may or may not be remembered. Sometimes we know of the aches and pains that are caused by arthritis, sore muscles, chronic back pain or an uncomfortable mattress, but many times we just don’t make the connection between our pain and the quality of our sleep.

It sounds like you’re one of those folks who sleeps more comfortably because there’s a reduction in your pain. If you don’t have any known muscle or joint pains during your waking hours, you might want to evaluate the condition of your mattress.

Narcotics like Lortab, Vicodin or Percocet are a bit different: Not only are they stronger painkillers than Tylenol or Advil, but they have opioid effects that are inherently sedating.

Q: I have never had a problem in 68 years of not being circumcised. Three weeks after buying shorts made in South America, I developed an itch on my penis that led to swelling of the head of my penis and an inability to retract my foreskin. What happened to cause a drawstring tightening? Is there any cream or salve that’ll relax the foreskin back to normal?

A: You’ve got “balanitis,” a marked swelling, pain and infection of the glands underneath the foreskin area of an uncircumcised penis. Balanitis causes so much swelling of the penis, that the foreskin may not be able to be retracted. It’s not an STD; rather it’s most often due to an overgrowth of bacteria or yeast normally present on the skin of the penis.

The only way I can attribute the balanitis to your shorts is if they somehow caused a persistent irritation/abrasion to the head of your penis. Balanitis can also come about as a result of using harsh bathing soap, poor hygiene, and poorly controlled diabetes.

The treatment of balanitis involves treating the underlying infection and reducing the inflammation to allow the foreskin to retract. Combination treatment with topical steroid cream, antibiotic cream or pills, and over-the-counter antifungal cream are very effective at resolving balanitis.

Only in the severest of cases is circumcision advised.

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