Blog About Health & Medicine

An article in Emergency Medicine (16# 14:69) contained some rather practical ideas about preventing headaches that migraine sufferers may wish to try.

It is especially important, the article emphasized, for these people to limit their intake of caffeine because, when taken in excess, caffeine can bring on attacks. An excess of caffeine is defined as taking more than 500 mg per day, an amount that is contained in five cups of strong coffee. The need for restricting one’s caffeine intake applies not only to one’s coffee drinking but also to one’s total caffeine intake from all sources.

Migraine sufferers must also eat very regularly, to the point that they get up for breakfast at the same time every day, even on weekends, in order to avoid hypoglycemia (low blood sugar), which can trigger migraine. For the same reason, they should always eat at regular intervals and avoid excess carbohydrates. Furthermore, they should not eat foods that are rich in tyramine (e.g., aged cheeses, chicken livers), sodium nitrate (found in cured meats), or sodium glutamate (which is widely used in prepared foods). It is also important to note that some migraine headaches are triggered by food allergies, which is the subject of the next article.

Migraine sufferers are much less tolerant of high altitudes than are normal persons and should take the drug Diamox (acetazolamine) before ascending. In addition, since they react to feminizing hormones, they should not take oral contraceptives or, after the menopause, estrogens for the prevention of osteoporosis.

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Exercising regularly and intensely enough to increase the pulse rate and make oneself short of breath, many physicians believe, will help a person overcome mental depression. Although there is no scientific proof for this, the Physician and Sportsmedicine (13#9:192) reports, many psychologists and psychiatrists are sufficiently convinced of a beneficial relationship between hard exercise and a positive frame of mind that they now recommend it routinely for all of their depressed patients if there is no health contraindication.

Mental depression of the type that responds to exercise (reactive depression) is defined as a feeling of sadness greater and more prolonged than is warranted by its cause. It is characterized by sadness, dullness, immobility, a sense of helplessness, and loss of self esteem. Depression that occurs without a triggering event and as a part of a severe mental illness (psychosis) will never respond to exercise alone, but requires psychotherapy and special medication.

One need not be a jogger or runner to overcome reactive depression, it has been found, and people who regularly engage in such activities as tennis, walking long distances, swimming, or rowing can benefit. To be of value, however, the exercise should be a kind that is somewhat demanding and also improves physical fitness.

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There is now good evidence to show that smokers’ lung cancer is due to radioactivity carried down into the lungs with smoke. Radioactive lead contained in tobacco is volatilized by the heat of burning and condenses onto the membranous lining of the airways, especially where the passages divide (bifurcations). Over the years, more and more radioactive lead (which “decays” into radioactive polonium) accumulates. Whether or not it stays at these sites largely depends upon how normal a person’s lungs remain.

If damaged beyond repair by tar and infection, the membrane’s lining cells lose their cilia (tail-like processes that, by constantly beating, waft inhaled particles up and out of the chest) and become unable to rid themselves of the radioactive contamination.

Eight groups of scientists recently wrote about this to New England Journal of Medicine, which published their letters together in the same issue (307:309). Most significantly, they reported, discovery of radioactive lead in smoke has been the most powerful anti-smoking influence they had ever encountered. News of it, apparently, has convinced many heavy smokers, for the first time, to stop smoking immediately.

It has also been found that the cancer-producing effect of smoking may not all be due to damage done directly to the lungs. According to the Medical Journal of Australia (2:425), the lymphocytes (one of the many types of white blood cell that defend the body against invading microorganisms) in smokers become much more sluggish than usual.

In particular, the ability of the lymphocytes to become “killer cells,” which attack any other cells of the body that begin to behave abnormally (e.g: become cancerous), is greatly reduced by smoking. This could explain why smokers have so many more infections than non-smokers, and why their tumors, such as melanomas, grow and spread more quickly to other parts of the body. Because the lymphocytes quickly regain their normal killer cell activities when smoking is stopped, it is never too late to give up the habit.

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According to a report in Arthritis and Rheumatism (25:1013), memory loss, inability to concentrate, and changes in personality are being encountered in elderly people who take one of the nonsteroidal anti-inflammatory drugs (NSAIDs) for arthritis. All of these drugs relieve pain, whether or not it is due to arthritis, and must therefore have some effect on nerve tissue.

Accordingly, it is not too surprising that they can affect the brain as well. Some of the most widely used drugs of this type include Clinoral, Motrin, Nalfon, Naprosyn, Rufen, and Tol-ectin. These effects have appeared after about two months of treatment and have disappeared completely within two weeks after the causative drug has been discontinued.

Because mental changes are so often ascribed to “senility,” be on the lookout for this side effect. Aspirin, as well, can do this, Clinical Pharmacology and Therapeutics (32:362) reports, but only with very high doses that are far greater than most people use.

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To make sure that our bones remain strong and are not too easily fractured in old age, it is essential that we get not only sufficient calcium (1.5-2 grams every day) but also enough vitamin D. Since vitamin D is responsible for efficient absorption of calcium from the diet and for calcium’ s retention by the bones, lack of this vitamin is now regarded as an often overlooked factor in the loss of calcium and the fractures that occur in so many older adults.

A poor dietary intake is not the only cause of vitamin D deficiency, Geriatrics (40#8:45) reports. Other causes include chronic diarrhea, gall bladder disease, kidney failure, absence of the stomach (after its removal because of an ulcer or cancer), alcoholism, liver disease, and certain medications (anticonvulsants and some cholesterol-lowering drugs).

Another factor, Geriatrics (42#7:30) reports, is that old skin is less efficient than young skin at producing vitamin D when exposed to the ultraviolet light in sunshine. Adults, in addition, are becoming increasingly concerned (and rightfully so) about skin cancer, which is likely to occur if the skin is exposed excessively to the sun. However, while minimizing exposure of our skin to the sun, we must take care as we grow older to avoid letting ourselves become deficient of vitamin D.

Normally, we need to get at least 400 units of vitamin D every day and may need twice that much if there is any doubt about our ability to absorb it. However, adults are less likely than children to take vitamin supplements (many older people try to save money by not buying them).

To avoid a vitamin D deficiency, Geriatrics recommends, elderly persons should be exposed outdoors to sunshine at least 15 minutes twice a week. When this is not possible, it is essential that they be given a supplement of the vitamin by mouth.

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