Thursday, November 26, 2015

Oh my aching head

No question about it, migraine headaches impact many people on a regular basis, preventing daily functioning and productivity.  To treat them, folks use a wide variety of preparations, both prescription and over the counter.  This feature on WBAL-TV was promoted by a new review article that looked at two agents, riboflavin and Coenzyme Q-10, in the prevention of migraines.  Enjoy the piece, then keep reading.

Although you might think from this news article that the use of these over the counter agents is a new finding, there are articles going back at least ten years that speak of the apparent efficacy of them in the prevention of common migraine headaches.  Riboflavin, which is also known as Vitamin B2, is a water soluble vitamin that is present in small amounts in just about every multivitamin.  There is, however, just the amount of the Recommended Dietary Allowance in these pills, about 1.7 mg.  For migraine prevention, the usually cited dose is 400 mg daily, taken as a single or divided dose.  There are capsules of 100 mg, 200 mg, and 400 mg available from a variety of sources.  Most references cite a two or three month lag time from starting the product until full effect is appreciated, and the mechanism of action, although there are lots of theories, is really unknown.  Because this is a water soluble vitamin, the excess that is unneeded by the body is excreted in the urine, which develops a lovely glowing yellow color as a result.  

Co-enzyme Q-10, also known as CoQ-10, is a naturally occurring substance in the body, which has anti-oxidant properties.  The most common use as a supplement is in people who are taking statins, where it appears to help minimize muscle cramps.  It has also been looked at for the prevention of migraines and, again, there does appear to be a positive effect in some studies.  Dosage appears to range from 150 mg to 300 mg daily, and, again, the studies do show a significant reduction without appreciable side effects.  

Whether these products can be used together is not clear, I was not able to find any references which used a combination.  As always, you should check with your physician before embarking on any therapeutic plan, whether by prescription drugs, over the counter products, or even techniques that don't involve ingesting something!  Be frank and open with your doctor, and you both will benefit.

Friday, November 20, 2015

Stuff Happens

You’re about to go out for a run or to exercise.  You have your shoes nicely laced.  You are wearing the proper clothing for the activity.  Got your music player, water bottle, sunglasses or hat.  But are your ready for the unexpected?  When you are out on the road or track, situations can arise that can significantly impact your health.  Here’s an article from Men’s Fitness in which I was interviewed about some of those dangers, and how to handle them.

Tuesday, November 17, 2015

Does your thermometer meter correctly?

Vital Signs have been a part of the medical examination since such examinations morphed into the age of modern medicine.  While men seem always to claim an extra inch on their heights, and women deny the accuracy of their weights, those minor aberrations likely do not impact their overall health management.  More than a few, however, when confronted with a temperature reading, claim that their temperature is always a degree or two low, saying such as, “I always run a 95° temperature.”  The truth is that their temperature is not being measured correctly, and this article speaks to this as more than a casual problem.

Thursday, November 5, 2015

A Sobering Statistic

The Center for Disease Control and Prevention, that arm of our government charged with monitoring the ills that befall our population, has come out with an alarming report.  No longer are cancer, heart disease, and lung disease the rising causes of death among a large segment of the population; but rather self inflicted ills including alcohol, drugs, suicide and resultant liver disease are now the most prominent.  The middle aged white man has done this to himself, and in this article from The Gupta Guide, my opinions of this study, and its implications, are examined.

Sunday, October 25, 2015

Legs feel weak as a baby?

Out there exercising at the top of your game when your legs feel too weak to hold you up?  Is this something serious, or is something more subtle going on?  Here is a look at this not uncommon situation, with the likely cause.  As well, there are thoughts as to how you can prevent the unsteady condition.

Sunday, October 18, 2015

I'm a Doctor, Jim, not a Provider

Do you go to a Doctor, a Physician, or a Health Care Provider?  If you see a Nurse Practitioner, is it an NP or a HCP?  Do you automatically call the person examining you "doctor" no matter what the degree or position?  It may seem trivial, but there are strong feelings about terminology, and this article looks at many reactions to the question

It’s always nice when someone else validates a view I have had for so long.  I totally agree that calling a physician a “provider” is just one more example of the dumbing down of language and blurring the lines between those caring for a patient.  In the effort to appease, English now has constructs such as “chairwoman,” which has no linguistic validity, and now “provider” for anyone involved in health care.  Thirty years ago I struck this term from documents and replaced it with “physician.”  I have asked those using the term just what I was providing?  If it was information and health education, then the word derived from the Greek word for teaching would be appropriate, and that word is “doctor.”  I wholeheartedly agree with the author’s position, and encourage my fellow physicians to throw the word “provider” back in the face of those promulgating it. Let physicians, nurse practitioners, physician assistants, and others be identified for their unique positions, skill sets, and range of practice.  We should be celebrating our educations and achievements, providing distinction and distinguishment to ourselves and our practices.

Thursday, October 8, 2015

Is the PCP a partner or a stranger?

In the case of devastating news, cancer or the like, is your Primary Care Physician, your family doctor who may have diagnosed the problem and sent you to the specialist, included in the healing process, or relegated to reviewing forwarded reports without being allowed any input?  Is that familiar hand not an important part of the treatment as well?  Here is an article which looks at this issue, with opinions from others as well as myself.