Friday, May 14, 2010

What Causes a Headache?



Not everyone suffers from headaches, but those that do often wonder why.  Twenty-eight million people in the United States suffer from various forms of headaches, according to doctors at St. John Chronic Headache and Migraine Institute.  Although a headache may seem like a simple ailment—pain in any region of the head, including sinuses, muscles, and blood vessels—the actual causes can be varied and often preventable.
 
Stress and Physical Causes

 Any type of stress can cause tightening of the muscle systems, which may lead to frequent headaches and migraines. Physicians at Virginia Hopkins have found that mind and body relationships are often disturbed by stressful situations, thereby disrupting sleep and causing headaches. For example, people under stress tend to grind their teeth during sleep, which places pressure on small mandibular joints just in front of the ear.  Sometimes it is just stress, but sometimes it can be due to dental problems. If one’s jaw or teeth are misaligned, one side of the jaw receives more pressure causing head pain.

 Drugs and Diet

           
Both prescription and over-the-counter medications are known to cause frequent headaches. This includes caffeine, alcohol, nicotine, and even medication given to patients for the treatment of headaches. The National Headache Foundation (NHF) suggests that it is often better to use a simple pain killer and wait out the headache, rather than inundating oneself with multi-symptom medicines.

Any type of substance abuse can cause not only frequent headaches, but also serious injury. Anti-depressants, sleeping pills, decongestants, and various beta-blockers can all cause painful headaches if overused.  Additionally, withdrawal from stimulants is a common culprit and is treated  by easing off the stimulant rather than stopping entirely.

Genetics

           
Genetic predisposition is often overlooked in cases of frequent headaches. Migraines tend to occur in early adulthood, accompanied by a sense of vertigo, and can often last for days. 

Headaches are more common in women than in men, suggesting a hormonal connection,  according to the American Headache Society. An increase in estrogen is known to cause vascular dilation and thus increase chances for recurring migraines. Frequent headaches in this category may be treated with progesterone cream to restore vascular tone and counteract the estrogen dominance. Many women and young adults suffering from these frequent headaches have found relief in the form of acupuncture, acupressure, meditation, and even simple relaxation techniques.



Saturday, May 1, 2010

Medicine, an excuse for living.

Medicine: An Excuse from Living

This article was immensely interesting to me and helped me rethink my decision for medicine. To me, balance is the most important thing in this life and finding that balance is also the trickiest thing one can do in life. As the article states: “as your practice grows, you will find your balance professionally…in your personal life.” The article was very positive and helped me to see what is actually important. It is difficult to see the war when you are fighting the daily battles on the front lines. The idea of this article is not to get too caught up in the heat of the battle and pay attention to the tides of the war. It also said that “some physicians will use their indispensability to patients as a way of life and the loved one can be made to feel guilty about taking the doctor away from a sick patient. It’s a rare family that will have the assertiveness to place their needs above the life or well-being of a patient.” The exploitation of guilt is merely a scape goat, a way to put off goals and aspiration and the needs of other members of the family. This is a serious problem and one I hope I will never fall into doing. One can very easily neglect the most important things and give excuses without realizing it. Family comes first as the saying goes, and we must always remember that. When I get into medicine, I promise never to neglect what is important, and although I will work hard to provide for my family, I cannot forget why I am working hard, and that is to make my family and myself happy. If my family is not happy I cannot be happy, and my family cannot be happy if I neglect them at the cost of my patients. It is something that is vitally important to the success of our society and our country, and ourselves. This article is all about family and deoting time and energy to the development of mature interpersonal relationships, regardless of recognition or rewards.

Interesting Article reviews

Asthma, Airway Inflammation and Treatment in Elite Athletes
Sports Med 2009: 35 (7)
Iikka Helenius, Aki Lumme, and Tari Haahtela

This article discussed how highly trained athletes are exposed to cold air during winter training and other allergens all throughout the year and that one should switch to less irritating environments whenever possible. The point was strongly made that it is difficult to change the natural course of asthma in athletes by anti-inflammatory treatment. I found it very interesting that the type of exercise and training can cause specific type of bronchial symptoms, bronchial hyperresponsiveness and asthma in most elite athletes. They listed the most common endurance athletes as cross country skiers, swimmers, long-distance runners, all of which experience mild asthma at some point. Apparently, the risk of asthma is closely associated with atopy. Atopy is basically when a hypersensitivity reaction such as asthma occurs in a part of the body not in contact with the allergen.
They discussed various forms of medical treatment in use of various antiasthma drugs to treat exercise-induced bronchial symptoms. In one study, they found that 17% of 253 Finnish elite summer-sport athletes used asthma medication in some form of inhalation. The funny thing is that despite widespread use of antiasthma drugs by athletes, few controlled studies have been conducted on the effects of inhalers, bronchial responsiveness, and airway inflammation. The article then discussed various forms of studies that have actually taken place such as the use of inhaled b2-agonists and leukotriene antagonists. They also discussed the increase use of fish oils and fatty acids with fighting inflammation. Some common environmental risk factors for allergic athletes include pollen season, cold ambient air, cold air and pollutants in indoor ice arenas, swimming halls, and dust/allergens indoor arenas for track and field.


Eating Disorders in the Male Athletes
Sports Med 2006; 36 (1)
Antonia Baum

This article discussed eating disorders in male athletes in addition to how this involvement in athletics fosters this disorder. Apparently they are less prominent than in female athletes, and therefore in danger of being missed. The article then discuss how to treat these disorders and what could be done. I learned a good new word: aetiology. They said that the participation in sports could contribute to the aetiology of eating disorder, but the opposite could also be true. The article then discussed different cases, in this following order: psychoeducation of athletes, their families, coaches and trainers, and other essential cases. I found it interesting that counseling an athlete to pursue a sport appropriate to his body type or to leave a sport behind altogether can be an important treatment. The point was also made that treatment can be structured using a biopyschosocial approach, and all appropriate modalities of therapy, including individual, family and group, as well as psychopharmacotherapy, which I do not exactly understand, but seems like a big word and important.
This article stated that eating disorders are an underrecognised problem in male athletes. There are some sports with particular vulnerability, including sports with an emphasis on asthetics, sports where low body fat is advantageous, and sports where you have to make weight for competition. Apparently, anabolic steroids also make a big difference in the disordered body image of male athletes. It seems that the best treatment is the biopsychosocial approach, where you involve friends, family, coaches, trainers, etc. The article concluded that future research was required to more firmly establish the reason and solution for eating disorders and behaviors. A delineation of sex differences in eating disorders is needed in both athletes and non-athletes. Interesting read, but never came to any great conclusion.



Wilderness Medicine
David A. Townes
Division of Emergency Medicine, University of Washington School of Medicine



The contents of this paper dealt with strategies for provision of medical support for adventure racing. I was previously not aware of such activities, but this article claims it is growing more popular. The idea is that in this multisporting, or adventure racing, athletes tend to perform multiple disciplines over a course in wilderness terrain. These can include hiking, trail running, mountain biking, cave spelunking, boating, and mountaineering. These races can apparently last up to 6 hours. The point of this paper is that presently there are no formal guidelines and small amount of literature to help with medical support plans during these events. This is probably due to lack of popularity, but that does not mean it should not be taken care of. The article provides an introduction to methods in providing provisions and medical support for these so called adventure races, since during these activities, it is necessary to address a wide variety of illnesses, and injuries. They stated that foot-related problems are the most common reasons for athletes to require medical attention during these events.
Since these races require utter rigor and rigid bodies, this paper also talked about the controversies involved in the provision for medical support during these events. Obviously, you don’t want your doctor to win the race, and if you are offered assistance, perhaps some form of a penalty should be addressed. The paper offered various penalities. Penalities included removal of the athlete from the event for medical reasons, and they also expounded the logistics of medical support communication, and liabilities. I at first was unclear as to the purpose of this and how useful it would prove, but as I read the article I realized that the information would be useful to medical directors of future adventure events. Event medicine is a new area that should always be addressed and discussed, especially when winning is involved.

Thursday, February 25, 2010

Dissatisfaction with the Medical Practice

Dissatisfaction with the Medical Practice

This article was somewhat depressing in that it pointed out some of the drawbacks in going into medicine, and the feelings that doctors have about their chosen profession. The summary in short is that there is a growing dissatisfaction with medical practice. One statistic said that California physicians were questioned in 1991 and again in 1996. The percentage of those who were less than fully satisfied with their profession choice rose from 53 percent to 63 percent. This article had a lot to do with happiness. Income does not always prove that there will exist happiness in one’s life, though once study says that physicians earning 250,000-299,999 a year were 98% more likely to report being very content with their medical career than those earning half as much. The article then went into what some of the known causes for this dissatisfaction and lack of happiness. Managed care was one possible major reason, namely those who are employees of HMOs, which affects the practice of medicine greatly. Secondly, there has been a great rising tide of medical-malpractice and an increase in trouble and disagreement between practicing physicians and their insurers. Thirdly, there is a change and difference in expectations among physicians and even patients. There is a discrepancy between standards set in a doctor’s training and the compromises forced by practice. A final and very important issue is time. Physicians feel they are not given enough time to either respond to patients are accomplish the tasks placed before them, and this in turn affects the mood and satisfaction of a doctor. It is unfortunate that the section for solutions is such a small portion of the entire article. The positive statement was made that intrinsic dissatisfaction in this profession can actually lead to significant social good. Once gain, it is not whether you fall down or get down on yourself, its what you do with this experience.

Wednesday, February 24, 2010

War of the Logos


Missile Defense Agency Logo


The new logo is causing quite a stir all throughout the country. I'm sure all the conspiracists are having a field day with this. What does it actually mean? My guess is nothing at all, but it will soon be changed, because the similarities are just too eerily close. Take a look at the new logo from the missile defense agency website below:


is what you get when you obviously mix the Islamic flag and another familiar logo.... :

 


As I said, this is likely a strange coincidence and I'm sure people in the agency are giving awkward side glances, particularly at the logo making department. Likely to be fixed is my prediction. But I'm sure people in the tea party will be shouting all sorts of slander and theories on this one. Just remember, you can draw connections from random places all the time:


Friday, February 19, 2010

Straight is the gate, narrow is the way...

That scripture, found in Matt. 7:13-14, is one explanation I have for the LDS bronze medal in U.S. church growth in 2009, according to newly released data by the National Council of Churches USA. Who won the gold? Jehova's Witnesses with 2.12% increase, and the Church of God of Cleveland TN holding the silver medal at a 2.04% increase. The LDS Church was at a 1.63% increase. Catholics aren't fairing so well...losing roughly 398,000 members, and Southern Baptists losing 40,000. This means that by the year 2180 there will no longer be any Catholics or Southern Baptists in the U.S.! In fact, in addition to the medal winners listed above, there was only one other church that had any growth in 2009, all the other churches in the U.S. either saw a decrease in growth or stayed the same.


Okay okay, now that I got your attention and some Mormons out there are depressed and wondering how they lost to the JWs, lets look at the actual numbers instead of the percentages:

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LDS Church: 95,736.5 (we love you 0.5, whoever you are)
Jehova's Witnesses: 23,153
Church of God of Cleveland TN: 21,494

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Ah, well there you have it. Gold medal for the Mormons. Congrats. Fastest growing church in the U.S. for 2009, thanks for playing everyone else. Now if we can just get those 95,000 to stay, we'll be in good shape!

Oh so that's the problem with some religions...

If I was Tiger Woods and my religion was Buddhism, I probably would have followed the same course of action as he did. Why? Because according to him, as spoken during a press conference this morning, his religion teaches him

"that craving for things outside ourselves causes an unhappy and pointless search for security."

What in the world does that even mean?? It is no wonder he struggled with moral decisions and holding back the watershed of temptation. You'd think Siddhartha Guatama might come out with something a bit more specific to help his followers. Other than hurting the feelings of his wife and losing sponsor contracts, I'm not sure I believe he understands why his actions were wrong, particularly in terms of the religious.
Thankfully, I am not Tiger and not a follower of such a vague religion with such vague and incoherent tenants. As a Mormon, I don't have such esoteric phrases to debate with in my mind. In Tiger's mind, during moments of temptation, it was Tiger vs. Buddhist theology, and Tiger beat it hands down. In my mind, during moments of temptation, I just don't stand a chance against my devout Mormon faith. Try as I might, I can't get past the impenetrable nose guard of Mormon theology. In addition to Biblical laws, we also have the Book of Mormon and D&C stating quite clearly:

"Thou shalt not commit adultery; and he that committeth adultery, and repenteth not, shall be cast out. But he that has committed adultery and repents with all his heart, and forsaketh it, and doeth it no more, thou shalt forgive."

If I could beat that one, I'd be going into law. It is not when our instinct fails that we need religion; it is when instinct kicks in that we need religion most, and when that religion can't deliver, I begin to question its source and authenticity. Otherwise, what is religion for? When a religion ceases to help mankind, it ceases to be a religion and becomes merely a hobby. I'm grateful for the specificity of my religion and the guidance it offers me in order to live a happy life.