Tuesday, August 5, 2014

Coffee, Science and Judgment

August 1, 2014

Photo credit: http://kristentorrestoro.myadventures.org/?

I’ve never fancied myself as a scientifically minded person, but I do like to know how stuff works.  And when I really want to know I will ask questions of every person who I think might have some possible insight.  I will ask and ask and ask, probably to the point of making an annoyance of myself.  That’s how I found out why coffee makes ibuprofen work better for my knee pain.

When I’m hurting badly and ibuprofen and/or acetaminophen just don’t touch it on their own, taking 800 mg (4 tablets) of ibuprofen with a mug of coffee brings the pain down to a bearable level.  Yes, I do know 800 mg is more than the recommended dose on the over-the-counter label but it’s less than you get with 1 prescription Advil.  And since I don’t do it every day my nurse friends tell me it’s a pretty safe dose.  For years now I’ve known that it worked but I didn’t know why.  And the “why” part bugged me.

Many years ago I worked with a man who had a prescription from his dentist for a cup of coffee every morning with whatever painkiller he was taking for otherwise untreatable tooth/jaw pain.  I rolled my eyes and thought he just liked coffee and needed the prescription to excuse it and keep his Temple Recommend so his wife wouldn’t kill him.  (He was, and I presume still is, LDS and drinking coffee is against the dietary code for Mormons in much the same way that Jews don’t eat pork.  As I understand it, the reasons are a little different but that a dietary code exists is similar.  For Mormons it’s a test of obedience while Jews are avoiding contact with an ‘unclean,’ and therefore harmful, substance -- for example, fat, naturally high sodium content, parasites and other diseases that would be readily transmittable because our body chemistry is so similar to swine that medical science can, today, use their organs for transplants in humans.)  I really didn’t give it much more thought until several years and a couple of jobs later when I found myself with a raging headache and a full afternoon of flashy PowerPoint presentations in a dark room ahead of me.  My boss handed me a couple of Advil and sternly told me to go get a cup of coffee and put my head down for 15 minutes.  Her persuasive powers finally prevailed…  And my headache went away.

I assumed it was the caffeine giving the painkiller a boost.  So, being Mormon myself, I tried to replicate the effect with other beverages.  I tried hot chocolate, Dr. Pepper, energy drinks, even caffeinated bottled water.  It didn’t work.  I got the energy bump but there was absolutely no effect on pain.

Ten years of asking everyone I met with any sort of science background and Googling it nigh to death… and I finally have my answer.  I met someone who knew and the patience to explain it in terms I understand.   FINALLY I know how it works!!

Caffeine is a nervous system stimulant.  That’s why you wake up or get the little energy bump from consuming it.  But caffeine is not the only stimulant in coffee.  The oil of the coffee bean contains bioflavonoids that specifically stimulate blood flow.  More blood, and consequently more of the painkilling and anti-inflammatory compounds in the ibuprofen, is delivered to the site of pain.  And that’s what gives the relief.

I really kind of love logical, tidy, simple answers like that!

The physician who explained this to me cautioned that the increase in blood flow is generally considered medically insignificant.  And, like any medication, the effect (pain relief in this case) doesn’t happen for every person who tries it.  But there is a growing body of documentation that for a certain segment of the population it is effective so maybe it’s more significant that medicine recognizes today.  And that is good enough for me.  There’s no guilt about having the occasional mug of coffee now that I know there is sound scientific reasoning behind my claim that it’s doing something positive in my body.  And I guess if I end up needing a prescription to justify it I can get past feeling so utterly silly asking…

Funny how sometimes it takes years for God to show you that your rash judgment of someone was way off base isn’t it?  Maybe that co-worker from years ago liked the pain relief more than the coffee.  I shouldn’t have assumed anything about his habits or motives.  I would do well to love more and judge less!

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