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March 2011

This Month We Spotlight Women's Health at Simplicity Urgent Care

Since March is Women’s History Month, we focus on some important women’s health issues in this month’s newsletter.

In the article below, Dr. Salma Haque helps women deal with headaches. While many factors contribute to headaches for both men and women, including family history and age, the fact that women have more headaches than men has for years stirred research into causes and new treatments. The discovery of a new class of headache drugs, the triptans, which work on brain chemistry, has helped to push headache research into mainstream science. Scroll down to learn more.

Heart health is also a big issue for women. In last month’s newsletter, Dr. John Maguire talked about the fact that there are two groups of patients that will commonly have unusual symptoms when they are actually having a heart attack: women and diabetics.

“Believe it or not, statistics show that about 267,000 women die of heart attacks each year — six times more than those who die of breast cancer,” Dr. Maguire explained. “The reason it’s such a big threat is that women who are having a heart attack often have atypical complaints, such as shortness of breath, nausea and / or vomiting, and back or jaw pain. They also experience flu-like symptoms, fatigue, extreme weakness, light-headedness, and cold sweats.” Read more here.

At Simplicity Urgent Care, our staff of experienced physicians, nurses, and technicians are dedicated to helping to treat your urgent care problems. We are also eager to help you understand the warning signs of potential long-term problems. Don’t hesitate to contact us with questions or concerns.

Here’s to your good health.Drs. John Jones and John Maguire, owners,

Dr. Salma Haque Helps Women Tackle Headaches

By Dr. Salma Haque
Simplicity Urgent Care

Have you had a headache recently? It’s not uncommon, especially in women, and an acute attack can range from annoying to completely debilitating. While some headaches are caused by the daily stresses of life, some do need your attention.

For starters, it’s helpful to be able to differentiate between tension headaches and migraines.

Tension headaches: These are the ones that usually develop after a long, stressful day. They are characterized by a dull steady pain often described as a tight band around the head, and usually affect both sides of the head, occasionally spreading to the neck or shoulders, and are non-throbbing.

Migraines: If you have ever had a migraine, you know it. They are characterized by throbbing on one side of the head, and are commonly associated with noise and light sensitivity. You may also have nausea or vomiting, visual symptoms, or tingling in the extremities prior to onset.

Migraine sufferers often have a family history of similar episodes. It is important to realize many people suffer from both migraines and tension headaches, and sometimes women will have a combination of the two.

Next, get familiar with the three tiers of treatment for migraines.

Acute abortive therapy. The first line of therapy for headaches is to abort an attack with over-the-counter anti-inflammatory drugs like ibuprofen, naproxen, aspirin, or a combination drug with acetaminophen, aspirin, and caffeine.

Prescription drugs. When these options are insufficient, I will prescribe a serotonin agonist (more commonly known as triptans), dihydroergotamines, or a butalbital-containing agent.

These drugs have been shown to be effective, but are associated with more side effects and are not tolerated by all patients. Anti-nausea medication often helps in patients with complicated migraines.

Preventative medication. If patients are getting migraines more than once a month, and they last for three days or more per month or are complicated, I recommend preventative therapy.

The most studied of these are beta-blockers (commonly known to treat high blood pressure), amytriptyline (an antidepressant), and some anti-seizure drugs (although side effects are more common). The best option is individualized to the patient. Keep in mind that preventative medication may take two to three months before a clinical effect can be appreciated.

Three Ways to Avoid Headaches

1. Be careful of the medications you take.

When pain relievers are being used more than twice a week, headaches can actually increase in frequency and lead to a cycle of daily headaches. If this is a concern, preventative therapy should be considered.

Unfortunately, a lot of patients are unaware of the rebound effect associated with frequent use of many of the migraine medications. Drugs that can cause rebound headaches with withdrawal include ergotamines, triptans, and butalbital, as well as medications that contain caffeine.

2. Keep a headache diary.

While there are common triggers, I recommend that my patients keep a diary of their own possible triggers whenever they develop a migraine. This helps them eliminate their personal triggers without becoming overly dependent on medication.

Common headache triggers include caffeine, alcohol, tyramine and nitrates contained in food, monosodium glutamate, too much or too little sleep, menstruation, missed meals, weather changes, high altitudes, flickering or glaring lights, and fatigue.

3. When you should be concerned.

1. If your headache develops after prolonged reading, computer and TV use, or while driving. A vision check, and new glasses, may be in order.

2. If you develop a fever, stiff neck, have a sudden onset of a severe headache, or a headache that is uncharacteristic of headaches you have had in the past.

3. If you have jaw and temple tenderness, confusion, weakness, vision changes, or other sensory deficits.

4. If you develop a new onset of headaches during pregnancy or after 50.

5. If your headache seems atypical, do not hesitate to immediately seek medical attention.

Speaking of drugs: In the April issue of our newsletter, Dr. John Jones will tackle the topic of prescription painkillers.

“While many people don’t worry about taking prescription narcotics for everything from severe toothaches to post-surgery pain, they may want to reconsider,” he says, pointing to a Feb. 17 report by the Centers for Disease Control and Prevention, which announced that the overall number of drug-induced deaths is approaching the number of deaths from motor vehicle crashes.

“There were more than 27,000 deaths from prescription drug overdoses in 2007, a number that has risen five-fold since 1990. That’s astonishing, and something that we want our patients to be aware of. While Simplicity Urgent Care is an acute care center, this is a growing problem and we look forward to discussing it.”