Migraine is more than just a headache
Headaches are one of the most common discomforts in life. The
International Headache Society classifies migraine as a primary headache
(that is without a known cause), with or without aura. An aura is a
disturbance of the nervous system that may cause sensations of flickering
light, shimmering or wavy lines – even loss of vision. There may also be
numbness, weakness, speech disturbance, dizziness or vertigo. These
symptoms develop over 5-20 minutes and last up to an hour. Headache often
follows, lasting 4-72 hours. Migraine with aura is called ‘classic
migraine’ and accounts for 1/3 of migraine sufferers. The remaining 2/3
have ‘common migraine’ which is defined as having at least two of the
following characteristics:
One-sided headache. (Sometimes both sides)
Pulsating in quality.
Moderate to severe intensity.
Causes avoidance of normal activity.
Associated with nausea or vomiting.
Made worse by light or noise.
Migraines run in families and affect women three times as often as men.
Whilst it is not fully understood how migraines develop, it appears that
certain triggers cause changes in brain activity. This affects small blood
vessels, which narrow then dilate. The stimulation of nerves to these blood
vessels may contribute to the pain of the headache. Women with frequent
classic migraine need to watch their blood pressure and avoid smoking and
the oral contraceptive pill to reduce their slightly increased risk of
stroke.
Often the symptoms of migraine will settle with rest and simple
painkillers like paracetamol, aspirin or ibuprofen. An anti-nausea
medication may also help. Some newer medications called triptans reduce
symptoms by altering brain chemicals. These work best if given early in the
episode or before the headache has started, if aura is present. Triptans
may cause adverse reactions with other medications including some
antidepressants. A daily relaxation practice such as meditation, yoga or
guided imagery can also help and can sometimes reduce the need for
medication.
Some people who use frequent painkillers (especially codeine and
triptans) for migraines are at risk of developing a withdrawal effect
-‘medication-overuse headache’. This headache is worse as the last dose of
medication wears off – usually in the early morning. There may also be
weakness, nausea, insomnia, irritability and memory loss. In this
situation, medications must be carefully reduced. The headaches may worsen
before eventual improvement.
If migraines occur frequently, there are a variety of ‘preventative’
medications available, although all have some side effects. Keeping a
‘headache diary’ for a few months will help you and your doctor to decide
whether such treatments are needed. Such a diary could include noting times
and severity of headaches, menstrual cycle in women and details of any
potential triggers (e.g. foods eaten, weather patterns or stressful
events). The diary will also help assess improvement with treatment.
While migraines can be distressing, many treatments are available. Your
doctor will help you find the best solution for your particular
situation.
Pasta and Noodles are increasingly popular
Pasta and noodles have become
everyday foods for many people. Nutritionally they are high in
carbohydrates with some protein and
almost no fat. Pasta and noodles are wrongly thought by some to be
“fattening”. This is not so. It is the addition of oil, butter, cream, or
fatty meat that adds unwanted calories and gives pasta and noodle dishes an
unfair reputation.
There is little difference between pasta and noodles. They have similar
ingredients and production methods. “Pasta” is an Italian word meaning
dough or paste. Dough is usually made from wheat flour mixed with water.
Eggs may be added. The dough is then cut into traditional shapes such as
long round strands - spaghetti, flat ribbons - fettuccine and tubes -
penne.
For those who need extra fibre in their diet, wholemeal and high-fibre
varieties of pasta are available.
Noodles originated in Asia. They can be made from wheat, rice, buckwheat
and mung beans. Noodles made from wheat often have eggs added. Wheat and
rice noodles are made in a variety of thicknesses. Buckwheat is used to
make soba noodles. Often a small amount of wheat flour is added to these
noodles. Mung beans are used to make glass or cellophane noodles.
Pasta and noodles can be used fresh or dried. If fresh, they need to be
used within 2-3 days. When dried, they can be stored for a long time. Most
pasta and noodle products are packaged with cooking instructions. It is
important not to overcook them.
Chicken with Rice Noodles
(serves 2-3)
2 skinless chicken breast fillets, thinly sliced
2 medium onions, chopped
2 cloves garlic, crushed
2 tsp grated ginger
1 tsp chilli sauce
1 tab soy sauce
1½ cups broccoli, chopped
200gm rice stick noodles
2 tab fresh chopped coriander
Marinate the chicken in garlic, ginger, chilli sauce and soy sauce for
30 minutes.
Cook noodles according to instructions.
Stir-fry onion in a little oil until it begins to soften. Add the
chicken and broccoli and stir-fry until cooked. Add noodles and coriander
and mix to combine over medium heat. Extra soy sauce may be added if
needed.
Myth and Fact
Myth:
Diabetics have sugar cravings.
Fact:
Diabetics do sometimes need an instant sugar “fix” to maintain their
blood glucose (sugar) levels. This is not a craving but a response to the
effects of insulin.
Insulin is a hormone (made by the pancreas) that is required to
transport glucose from the bloodstream into cells. Type 1 diabetics cannot
produce insulin and need regular injections to survive. Type 2 diabetics
can take medications to help the pancreas to produce more insulin, though
may eventually need injections.
If the levels of glucose in the blood become too low following an
insulin injection, the brain will not be able to function properly. This is
called a ‘hypo’ or hypoglycaemia. If glucose levels are not quickly
restored, the sufferer may become quite strange in their behaviour,
ultimately losing consciousness. Diabetics on medication are advised to
keep jellybeans or other form of readily absorbed glucose on hand in case
of a ‘hypo’.
A man asked his doctor quite frankly what was wrong with him. “Well,” said the doctor, “you eat too much, drink too much, and you are terribly lazy.”
“Thanks,” the patient replied, “but would you be kind enough to put that
into Latin. Then I can have a week off from work.”
UTIs are a common problem for women
Urinary Tract infection (UTI) refers to an infection in the bladder,
kidneys or any of the tubes connecting these. Infection most commonly
occurs when surface bacteria enter the urethra (the tube that drains the
bladder), which in women is situated within the vagina. In women, the
urethra is relatively short so it is easy for bacteria to make their way to
the bladder where they can enjoy a warm, moist environment and multiply
rapidly. Infection in the bladder is called cystitis.
Bacteria occasionally travel back up the ureters (the tubes that connect
the kidneys to the bladder). They are usually hindered in this by valves
that stop urine flowing backwards. If bacteria manage to settle in the
kidney, the resultant infection is called ‘pyelonephritis’. Pyelonephritis
is a serious infection that can spread directly to the bloodstream and the
rest of the body.
Symptoms of UTI include:
Wanting to urinate more often (frequency)
Feeling the urge to urinate even if only a few drops (urgency)
Burning pain or a ‘scalding’ sensation on urination
A feeling that the bladder is still full after urination
Pain above the pubic bone
Blood in the urine.
Signs of pyelonephritis include back/loin pain, fever and chills.
The symptoms of UTI can be helped by increasing fluid intake (to flush
out infected urine) and making the urine more alkaline (less
bacteria-friendly). Antibiotics are often required to clear infection.
Cranberry juice has been shown in some trials to reduce the frequency of
UTIs. If you are taking regular cranberry products, let your doctor know as
it can affect some antibiotics.
While women are at risk because of their anatomy, men with prostate
problems and diabetics may also be prone to UTI. Preventing infection
involves drinking plenty of fluids, maintaining good hygiene around the
urethra and making sure the bladder is emptied fully. One strategy for the
latter is ‘double-voiding’. After urination, a second attempt to urinate
after waiting a minute or two, may release any urine left in the
bladder.
Did you Know?
Microwave cooking can be dangerous
A recent report of a serious penetrating eye injury, caused by the
exploding yolk of a microwave-cooked poached egg, is a timely reminder to
take care when using the microwave. Microwaves can generate high pressure
within sealed objects – such as the yolk of an egg. Manufacturers recommend
that eggs or packaged products be pierced before cooking to avoid pressure
build-up. The combination of heat and pressure can result in significant
injury!
Low salt diet helps resistant BP
A recent Australian study looked at people with ‘resistant hypertension’
- that is high blood pressure that is difficult to treat as it doesn’t
respond well to medications. They found that patients had a marked response
to a low-salt diet of 50mmol/day. Many who think they are on a low-salt
diet are actually still consuming large quantities. A dietitian may be
needed to assess intake.
The Big Stretch
This is about exercise and whether some attempts to avoid injury and
muscle pain work. But let me first remind you about the huge benefits of
exercise. Exercise reduces the risks of diabetes, dementia, heart disease,
breast cancer and probably bowel and prostate cancers too. So it’s a
pretty good thing to do. Some people though, fear that they may pull
muscles and don’t like the soreness that you sometimes get after pushing
yourself a bit hard, which is why you often see people stretching before
exercise. Me, I can’t be bothered – but who’s right?
Well the evidence has been pretty dubious, so researchers in Australia
and Norway decided to do a trial, monitoring participants online. People
were allocated either to a group who stretched seven muscle groups for 30
seconds each before and after a bout of exercise, or to a control group.
They were asked to report on muscle soreness and injuries.
The results found a small effect on soreness. Thirteen people had to
stretch for one person to avoid the pain. Strains and sprains were
prevented but the size of the effect was not impressive. The researchers
calculated that a person has to stretch for 14 minutes per exercise
session, for five or so years, to prevent one strain or sprain - although
younger people had more benefit than the more mature.
So if you can’t be bothered to stretch, it’s unlikely you’re missing
much.
Watch out for drink spiking in public places
Drink spiking refers to the practice of adding any substance to someone
else’s drink without their knowledge. It is illegal in many countries and
can lead to potentially serious physical and psychological harm.
Some researchers have found that while drink spiking may be associated
with sexual attack, most incidents are considered to be practical jokes or
pranks. The most frequently used substance is alcohol. Sedatives and party
drugs like GBH are less commonly used to spike drinks. Alcohol poisoning
may occur, requiring hospital treatment. Most victims are female and under
24 years of age, although it can happen to anyone. Take care when drinking
in public places and ensure that you do not leave your drink unattended nor
accept drinks from strangers.
