Tag Archives: Pasadena

Headaches: When to Call the Doctor

By: TRANG M. PHAM, M.D.

Headaches are our most common form of pain and a major reason for trips to the doctor. While most headaches are just a temporary nuisance, sometimes they can warn you about a serious health problem that needs immediate attention.

Causes of headaches

Headaches happen when nerve endings in your body react to triggers and send pain messages to your brain. Chemical activity in your brain, the nerves or blood vessels surrounding your skull, or the muscles of your head and neck can play a role in headaches.

A primary headache is caused by problems with pain-sensitive nerves in your head and is not a symptom of another medical problem. Primary headaches can be triggered by lifestyle factors, such as stress, alcohol (especially red wine), certain foods (such as processed meats with nitrates), poor sleep and poor posture.

A secondary headache is related to medical conditions that trigger pain-sensitive areas in the neck and head, including a neck injury, eye problems, and infections in your jaw, teeth, or sinuses. More serious causes of secondary headaches can be brain tumors, aneurysms, and meningitis.

Types of headaches

There are many types of headaches, but three of the most common are tension, cluster, and migraines.

Tension headaches are the most common kind and are often brought on by stress and tight muscles. Symptoms include:

  • Gradual start
  • Head usually hurts on both sides
  • Pain is dull or feels like a band or vice around the head
  • Pain may involve the back part of the head or neck
  • Pain is mild to moderate
  • Typically, does not cause nausea, vomiting or sensitivity to light

Cluster headaches usually occur in a series that may last weeks or months. They are more common in men than women and may be caused by alcohol use, smoking cigarettes, bright light, exercise/exertion, hot weather or water, and foods with nitrates, such as bacon or lunch meat. Symptoms of cluster headaches include:

  • Severe pain on one side of the head, usually behind one eye
  • The eye that is affected may be red and watery with a droopy lid and small pupil
  • Swelling of the eyelid
  • Runny nose or congestion
  • Swelling of the forehead

Migraines mostly affect women. The average migraine lasts from four hours to three days, but severe attacks can last longer, badly impacting your work, family, and social life. In addition to headache pain, migraines can include:

  • Nausea and vomiting
  • Lightheadedness
  • Sensitivity to light and other visual symptoms, such as flashing spots, wavy lines, and blurred vision

Treatment depends on the headache

Effective treatment depends on what type of headache you have. It may include:

  • Avoiding known triggers, such as certain foods and beverages
  • Stress management
  • Changing eating habits
  • Exercise
  • Resting in a quiet, dark place
  • Over-the-counter medications or prescriptions from your healthcare provider

Migraine and cluster headaches may need specific medicine management:

  • Preventive medicines: Prescribed by your healthcare provider and taken daily to reduce the onset of headaches.
  • Abortive medicine: Prescribed by your healthcare provider and acting on specific nerves and blood vessels in the head to stop a headache in progress.
  • Rescue medicines: Over-the-counter pain relievers to stop the headache.

When you should call your doctor

Most headaches can be treated with over-the-counter medicine and will go away on their own. But there are times when they can be a symptom of serious medical conditions, such as a blood clot, aneurysm or tumor in the brain, concussion, encephalitis, meningitis, or stroke. Call your healthcare provider immediately if you experience a sudden, severe headache with:

  • Fever
  • Nausea
  • Vomiting
  • Convulsions
  • Shortness of breath
  • Confusion
  • Muscular weakness
  • Double vision
  • Change in level of consciousness

If headaches are an unpleasant part of your life, contact your MPCP healthcare provider to discuss what can be done to help you feel better.

 

Trang Pham, M.D.Dr. Pham is a MPCP partner and cares for patients in the Pasadena office. She holds her medical degree from Jefferson Medical College and is certified by the American Board of Family Medicine.

Careful with the Caffeine

By: PAUL CHITE, M.D.

For most adults, caffeine helps us wake up in the morning and gives us a pleasant boost during the day. There are a variety of available caffeinated products to suit any taste, from tea and coffee to energy drinks and chocolate.

Caffeine is a stimulant, and its effects increase with the amount consumed. Up to 400 milligrams (mg) of caffeine a day is safe for most healthy adults. That’s the equivalent of about four cups of brewed coffee, 10 cans of cola or two “energy shot” drinks. (See the chart below for the caffeine content of popular drinks.)

Health downsides
As you may know from experience – for example, on days you drink more coffee than usual — too much caffeine can cause some unpleasant side effects. Common side effects include headaches, feeling jittery, increased urination, and irritability. Most side effects are mild, but others are more serious and can cause health problems such as:

  • Trouble sleeping: Too much caffeine can cause difficulty falling and staying asleep. Even moderate amounts can cause insomnia in some people, especially if you have it too close to bedtime. In fact, caffeine can stay in your system for up to eight hours after you consume it. Lack of sleep can contribute to health problems – such as mood disorders and obesity — so avoid caffeine in the afternoon and evening if you notice it affects your sleep.
  • Faster heart rate: Caffeine causes your heart to beat a little faster. That’s not a problem for most of us, but if you consume too much, your pulse may stay high too long. It may even feel like your heart beats in an irregular rhythm, sometimes called heart palpitations. Excessive caffeine may even trigger episodes in people who have certain heart conditions, such as atrial fibrillation.
  • Raised blood pressure: Caffeine can spike your blood pressure for a short while and sometimes over the long term. High blood pressure is linked to other health problems, including heart and kidney disease, so talk to your doctor about how much caffeine you can take if you have high blood pressure.
  • Worsened menopause symptoms: Women experience the change of menopause around age 50, and caffeine can increase the sudden hot flashes that often happen at this time of life.

Many teens enjoy sugary coffee drinks or caffeine-laden energy drinks, but teens are especially sensitive to caffeine’s effects and should avoid it. Also, caffeine can interfere with fetal development, so women who are pregnant or are trying to become pregnant should talk with their health provider about limiting caffeine use.

Curbing your caffeine habit
Your body gets used to a certain level of caffeine, so if you decide to quit it all at once, you may experience withdrawal symptoms, such as headaches and fatigue. These symptoms are usually mild and resolve after a few days.

A better approach may be to gradually reduce the amount of caffeine you consume until you are caffeine-free. Try these methods:

  • Cut back slowly: Try drinking one less cup of coffee or one less soda each day or drink a smaller cup of coffee. This will help your body get used to the lower levels of caffeine.
  • Switch to decaf. Most decaffeinated beverages look and taste much the same as their caffeinated counterparts.
  • Shorten brew time or go herbal. When making tea, brew it for less time. This cuts down on its caffeine content. Or drink herbal teas that don’t have caffeine.
  • Avoid energy drinks: Caffeine is a main ingredient of many energy drinks, so it’s best to avoid them.

 

Typical caffeine content of popular drinks

Coffee Sizes Caffeine content (mg)
Brewed 8 oz. 96 mg
Brewed, decaf 8 oz. 2 mg
Espresso 1 oz. 64 mg
Espresso, decaf 1 oz. 30 mg
Teas Sizes Caffeine content (mg)
Brewed black 8 oz. 47 mg
Brewed black, decaf 8 oz. 2 mg
Brewed green 8 oz. 28 mg
Bottled 8 oz. 19 mg
Sodas Sizes Caffeine content (mg)
Cola 8 oz. 22 mg
Root beer 8 oz. 0 mg
Citrus-flavored 8 oz. 0 mg
Energy Drinks Sizes Caffeine content (mg)
Energy drink 8 oz. 71.9 mg
Energy shot 2 oz. 215 mg

Source: Mayo Clinic

 

Paul Chite, M.D.Dr. Chite cares for patients in the Pasadena office. He earned his medical degree from American University of the Caribbean, Saint Maarten, and is certified by the American Board of Family Medicine.

Not Just a Headache: The painful facts about migraines

By: TRANG M. PHAM, M.D.

More than one in 10 Americans suffer from migraines, but unless you experience them yourself you may have no idea how painful and crippling they can be. Here’s what migraines are and what can be done about them.

Migraine is more than just a bad headache

The cause of migraines is not well understood, but researchers believe they are a neurological disorder caused by brain chemistry imbalance. They cause intense pain (called an attack) that can be throbbing or pounding. But unlike headaches, they often come with other symptoms like sensitivity to light and sound, as well as nausea and auras.

Migraines can be with or without auras

Migraines occur with auras 25%-30% of the time, but they often happen without them. Auras come in many forms, including:

  • Flashing spots
  • Wavy lines
  • Blurred vision
  • Unusual smells
  • Ringing in the ears
  • Tingling sensations in your face or hands

Migraines can happen often and last a long time

Unlike headaches, which are usually short in duration, the average migraine lasts from four hours to three days — but severe attacks can last weeks, badly impacting a person’s work, family and social life. Some unfortunate people get migraines on 15 or more days per month, a condition called chronic migraine.

Anyone can get migraines

Migraines are more common in women (18%) than men (6%), but children also get them. They happen more in boys than girls, but that seems to switch in the teen years. Migraines seem to peak between the ages of 30 and 49.

Migraines are a serious medical condition

Besides the pain, research indicates a link between migraine and serious health issues, including heart disease, stroke and even suicide:

  • Migraine can increase the risk of heart disease, including heart attacks and angina.
  • It can also raise the risk of stroke, coronary events, and other related deaths by 50%.
  • Suicide attempts are three times more likely among those who have migraines compared to those with no history of migraines.

There are effective treatment options

A cure for migraines is still to come, but there are treatment options that can reduce their frequency and severity. For example, a healthcare provider skilled in migraine management can help you identify and manage factors that may trigger attacks, such as:

  • Stress
  • Hormonal changes in women, including those from oral birth control or hormone replacement therapy
  • Alcohol
  • Bright lights and glare from the sun
  • Loud noises
  • Not getting enough sleep or poor sleeping patterns

Your healthcare provider may also prescribe several types of medicine:

  • Pain-relieving medications – Once a migraine attack begins, you take these to reduce its severity.
  • Preventive medications – You take these to reduce the number of migraines and their severity. You may use them on a daily basis.
  • BOTOX® injections: BOTOX is the only FDA-approved, preventive treatment that is injected by a healthcare provider. MPCP offers BOTOX injections for adults with chronic migraines – they can prevent up to nine headache days a month. Talk to your provider to see if you are eligible, or click here to learn more.

Your healthcare provider can diagnose migraines

If you suspect migraines, no lab or imaging tests are needed to confirm it. Your MPCP provider can make the diagnosis with a medical history and physical exam. In some cases, they may refer you to a migraine specialist.

 

Trang Pham, M.D.Dr. Pham is a Maryland Primary Care Physicians, LLC partner and is certified by the American Board of Family Medicine. She earned her medical degree from Jefferson Medical College and sees patients in the Pasadena office.

Racial Disparity in Breast Cancer

By: TRACY JANSEN, M.D.

Breast cancer rates among white women are higher than those for minority women, but black women are more likely to die from breast cancer. This article explains racial disparities in breast cancer and ways women can reduce their risk.

The basics of breast cancer

Breast cancer is a disease that causes cells in the breast to grow out of control. Breast cancer is the second most common cancer in women in the U.S. (after skin cancer). Deaths from breast cancer have declined over time, but remain the second leading cause of cancer death among women overall and the leading cause of cancer death among Hispanic women. Black women are 40% more likely to die from breast cancer than white women.

What puts you at risk

Your risk for breast cancer is due to a combination of factors. Some are lifestyle issues ‒ such as lack of exercise, obesity, and alcohol use ‒ but the two main factors are ones you can’t control: being a woman and getting older. Most breast cancers are found in women who are 50 years old or older. Your risk is also higher if you have a family history of breast or ovarian cancer.

Differences in breast cancer by race

  • White women are slightly more likely to develop breast cancer than black, Hispanic and Asian women.
  • Among older women, white women have higher rates of breast cancer compared to black women.
  • Black women are more likely to develop more aggressive, more advanced-stage breast cancer that is diagnosed at a young age.
  • Black women are more likely to have breast cancer diagnosed later when treatment options become limited and the survival rate is poor.
  • Genetic factors may make black women more susceptible to certain types of cancer.
  • Lifestyle factors – such as being overweight and not exercising – are linked to higher risk.
  • High rates of type 2 diabetes in black women may be a factor. Women who had been diagnosed with diabetes at least five years prior to their breast cancer diagnosis were almost twice as likely to die of the breast cancer.
  • Economic factors, such as lack of health insurance, limited access to medical care, and lack of access to nutritious foods, may contribute to higher cancer risk in minority women.
  • Women who don’t breastfeed are at higher risk. Breastfeeding rates are lower among blacks than whites.

While there may be some factors you can’t control, such as a family history of breast cancer, there are steps you can take to lower your risk, whatever your race:

  • Maintain a healthy weight. Ask your doctor about healthy ways to do this.
  • Be physically active. Most healthy adults should aim for at least 150 minutes a week of moderate aerobic activity or 75 minutes of vigorous aerobic activity weekly.
  • Limit alcohol. Limit yourself to no more than one drink a day, as even small amounts increase risk.
  • Breast-feed. The longer you breast-feed, the greater the protective effect.
  • Limit postmenopausal hormone therapy. Talk with your doctor about the risks and benefits of hormone therapy.
  • Get screened. The American Cancer Society recommends women 45 to 54 get mammograms every year, and women 55 and older get them every one to two years.

Learn more about breast cancer and what you can do to lower your risk.

Tracy Jansen, M.D.Dr. Jansen is an MPCP partner and is certified by the American Board of Family Medicine. She cares for patients at the Pasadena office.