Penny plain about migraine.

Couple of years back when I was a newborn in the field of medicine (still I am!!), I had my first migraine attack in the anatomy lecture hall. I had a slight headache that morning. Towards the end of the class I couldn’t see anything; it was much the same as a dark screen before my eyes for few seconds. I couldn’t understand what was occurring to me and scarcely I could stand, I simply lost adjust of myself and with the assistance of my friends I just sat there in the class for couple of minutes and immediately consulted our physician.
After sometime I had a very severe throbbing right sided headache. It was so painful that I felt someone was hammering my skull consistently from inside to break out. I couldn’t withstand sound of vehicles or any noise which aggravated the headache. I was prescribed medications for a month which had got me a relief.

In spite of that one can get migraine under stress. Migraine can be very much disabling as you cannot focus on your work. Its global prevalence is 14% worldwide and more common among women.

Migraine headache usually affects one half of the head, which is pulsating in nature, and lasts from 2 to 72 hours. It is associated with sensitivity to light; movement, sound and nausea (a feeling of physical unwellness, usually with the desire to vomit) and vomiting often accompany the headache.

People who are mainly affected are
– Women
– Teens
– People who sit in front of computers for long time.
– People of age group between 20 and 55.

What causes Migraine-?

– too much booze.
– excess sleep or lack of it.
– stress and
– whether changes.

Others:

– Bright lights and Glare.
– Hunger.
– Physical exertion.
– Hormonal fluctuation during menses.
– Too much Chocolates.
– Too much Cheese.

Facts about migraine
– Depression is three times more common in people with migraine(WHO)
– Migraine attack is among the most disabling illness, comparable to dementia, quadriplegia, and active psychosis. (W.H.O)
– In study most dog owners said their pet recognized their migraine before they did themselves, or during early visual phases and the dogs would typically show unusual attentiveness.
– Migraine sufferers have increased risk for suicide attempts.
– People with migraines have an increased risk of stroke especially among women.
– Medications (NSAIDS like acetaminophen, iboprophen, narcotics and triptans (serotonin receptor agonists prescribed for migraines like sumatriptan, rizatriptan etc) over use can cause migraine.

What can we do to prevent?

– Keep well hydrated since dehydration may trigger migraine.
– Exercise regularly.
– Yoga.
– Meditation.
– Head massage.
– Avoid excess pain killers.
– For immediate relief during work just have a cup of coffee.
– Neem/Indian Lilac (as soup and pickled neem leaves) and clove.

Diet modifications.

Diet rich in Omega 3 Fatty acids can relive headaches.

– Sea foods like salmon and mackerel which contain omega 3 fatty acids help to relive headache.
– Spinach cooked, boiled without salt is also said to relief.
– Flax seeds (Cookies, Bread, Oats).
– Walnuts and walnut oil.
– Soybeans.
– Lavender oil and Eucalyptus Oil (Application over the temples, forehead to soothe a headache).

If you develop any of such symptoms, it is advocated to consult your doctor as early as possible as there are conditions which mimic migraine headache having bad outcomes like –
– Intracranial Hemorrhage (Common in Hypertensive, diabetics, smokers and alcoholics.)
– Cerebral aneurysms (Common in Hypertensive, diabetics, smokers and alcoholics.)
– Space occupying lesions
– Cluster headaches and dissection syndromes.

Burns.

What would you feel when you wake up one day with pain everywhere all over the body? Not able to think clearly and not recalling any past events how you ended up in hospital and now with excruciating pain and can’t even move your limbs. It is the saddest incapacity I ever felt when I was working in the burns ward. The first time when I entered the burns ward I could feel the change in the earth. I could see the faces of patient attendees wearing the mask of sorrow and depression. They would ask every doctor who used to visit the burns ward to know about the condition of the patient. After conversing with all of them of them would say in regards to the torment.

Pain can be classified as Somatic (pain after you would have experienced after fall from the bicycle), Visceral (dull and vague pain caused due to problems in the stomach, bladder etc.) and Neuropathic pain (tingling sensations, burning, pins and needles sensations felt due to injury to spinal cord or peripheral nerves).

But what about the emotional pain or the psychological trauma felt after the burns? Most of the burns were due to accidental as well as suicidal and rarely homicide. The greater part of the female patients would sob peacefully while taking the history about the event. It was an exceptionally miserable and unforeseen minute for me which I had encountered surprisingly. Life can be some of the time truly sudden and unexpected.

The psychological pain or emotional trauma can have prolonged bad impact on the quality of life. It’s not the present, but rather the past events will have the impact and it leads to insecurity about oneself.

The reason uncovered after the search was that because of the perception of event happened by our brain. Our brain neurons are designed in such a way that they change in response to external stimulus, store information and promote survival. Internal representations are made in our brain based upon the external stimuli. Over a period of time neurons become sensitized and even less stimuli can cause considerable emotional pain or suffering. This is also the mechanism of some of the psychiatric disorders and among children, the change in behavioral pattern caused later in life due to child abuse, or any major disturbing event in life which can be as extreme as violent behavior and even a murder.

It is equally important to take care of the emotional well-being along with any medical disability which could be done with the help of support from the family, healthcare faculties, friends and from educational and non-government organizations.

Rapid improvement can be seen if the support comes mainly from the family members. Especially in a country like India where burn injuries are common among the poor society, most are accidental and suicidal. But according to my knowledge after working in burns ward it was quite surprising that accidental burn injuries turned into suicidal and suicidal into homicidal. So it needs a watchful assessment of the patient and regarding the follow-up.

Management can be at various levels but at the individual level behavioral modifications like joining a self- help groups, hobbies etc. Be that as it may, the best practice which has changed the lives of millions is Meditation. That is the best treatment which I can prescribe for any individual who has had any sort of psychological trauma/ emotional pain.

I need you to engrave the words in your brain by my most loved author Dr.Viktor. E .Franklin an Austrian neurologist, psychiatrist and a holocaust survivor from his book “Those who know how close the connection is between the state of mind of a man-his courage and hope, or lack of them-and the state of immunity of his body will understand that the sudden loss of hope and courage can have a deadly effect”.

Maternal and Infant Care.

My very first post….

Maternal and infant care.

One thing which fascinated me when I was working in OBGY department was mother’s card(Thayi Card). In this document all the details of a pregnant women are recorded starting from the day when a woman is diagnosed to be pregnant. All the events are recorded in this card from 1st trimester and till the new born is vaccinated according to the immunization schedule. It is a very useful tool, about which most of the people do not know. It contains details like demographic data ,last menstrual period,expected date of delivery,blood group and other tests which are very useful for a doctor to plan and manage the pregnancy very effectively for the safe delivery.

The thayi card can be obtained from the nearby PHC or sub-centers where the pregnant mother has been registered for regular antenatal care visits. Thayi card can also be obtained from Anganwadi workers, ASHA( Accredited Social Health Activist)worker and ANM(Auxiliary Nurse Midwife).

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Thayi card contains two sections :

-Mother’s details like supplementation of iron tablets, Folic acid tablets, vaccines etc.

-Child’s details like vaccines given as per schedule etc.

The main objective of this ANC (Antenatal care)registration card was to reduce Maternal mortality rate and Infant mortality rate by the programme called Jnani Suraksha Yojana under NRHM(National Rural Health Mission).

But during my rotation what I observed most of them do not know any thing about thayi card .It  was very surprising and upsetting.

It may be due to multiple factors like limited facilities available to them or poor management, very few ANM/ASHA workers, lack of awareness about the scheme and so on. Thus, many social, economical, cultural and environmental factors determine how best we can deliver the health care to people.

At the same time I feel that there should be some effort from the multitude as they are the one who are benefiting from the schemes and some people in spite of having knowledge about the card they do not register and undergo no regular antenatal visits.

There is a need to educate the people, creating awareness regarding this scheme, as it has very good advantages if used properly and it would definitely reduce the maternal deaths and infant deaths.

 

 

For further details visit:

http://bjpkarnataka.org/wp-content/uploads/2013/10/Health-and-Family-Welfare.pdf
http://karhfw.gov.in/demo/MCTS.pps