Health Care

Introduction

The best way to manage migraine headaches is to avoid them. By identifying and avoiding migraine triggers, you can help reduce the frequency and severity of attacks. While some triggers may be out of your control, others are easily avoidable. The following points can help you prevent a migraine:

• Identify your migraine triggers in a headache diary(What is a PDF document?) .
• Get regular sleep and activity.
• Eat regularly, and do not eat foods that are likely to trigger a migraine.
• Manage stress.
• Avoid smoking and secondhand smoke.

What are common migraine triggers?
Why identify and avoid migraine triggers?
How to identify and avoid headache triggers
Where to go from here

Return to topic:

Where to go from here

Now that you have read this information, you are ready to start identifying and avoiding migraine triggers.

Talk with your doctor

If you have questions about this information, take it with you when you visit your doctor. You may want to use a highlighter to mark areas or make notes in the margins of pages where you have questions.

Take your headache diary with you when you visit your doctor. Be sure to let your doctor know if you are noticing changes in your symptoms.

Talk with your doctor about what might be triggers for you. Discuss ways you can avoid those triggers.

Prevention

You may be able to reduce frequent migraines by avoiding triggers, such as certain foods, stress, and changes in your daily routine, although it is not clear how or why these events lead to migraines. Some common triggers of migraines include:

• Consuming certain substances such as chocolate, monosodium glutamate (MSG), red wine, and caffeine.
• Getting too much or not enough sleep.
• Fasting or skipping meals.
• Changes in the weather or barometric pressure.
• Stress or intense emotions.
• Strong odors or cigarette smoke.
• Bright lights or reflected sunlight.

Your doctor may also prescribe drugs to help prevent migraine headaches.

Exams and Tests

Your doctor will be able to diagnose cluster headaches with a medical history and physical exam. Cluster headaches have a classic set of symptoms, so your doctor usually can make a diagnosis based on your description of the headaches. Imaging tests are not commonly needed to help find a treatment for your pain.

If your cluster headaches are not helped by treatment, become chronic, or didn’t begin until you were over age 50, your doctor may order imaging tests to rule out other causes for the headaches. Imaging tests may also be ordered if the pattern or symptoms of your headaches change, you develop a serious medical condition such as cancer or diabetes, or the headaches are triggered by physical exertion, sex, coughing, or sneezing.

If you need imaging tests, you may have a:

• Computed tomography scan (CT scan) of the head. A CT produces detailed pictures of structures inside the body. It can also detect serious but uncommon medical problems such as brain tumors.
• Magnetic resonance imaging (MRI) of the head. An MRI can detect changes in the normal structure of your brain. It may be ordered to rule out other serious medical problems such as brain tumors, blood clots, or a bulge in the wall of a blood vessel (aneurysm). But most headaches are not caused by these more serious conditions.

Talking with your doctor may help you decide whether to have imaging tests to evaluate your headaches. For more information on this decision, see:

Should I have imaging tests to evaluate my headaches?

If your symptoms are not clearly related to cluster headaches, your doctor may order additional tests such as blood or urine tests to rule out other causes.

Exams and Tests

Your doctor will diagnose a migraine by asking you questions about your health and lifestyle and by examining you. There are no lab tests that can confirm a diagnosis. Migraines can be difficult to diagnose because symptoms resemble those of other headache conditions. For example, many people have been diagnosed with sinus headaches when they actually have migraines. As a result, migraines are underdiagnosed and undertreated.

Your doctor may use the International Headache Society’s criteria to diagnose migraines. You may be diagnosed if you experience 5 or more headache attacks without an aura (or 2 attacks with an aura) that last from 4 to 72 hours without treatment and are accompanied by symptoms of nausea, vomiting, or sensitivity to light or noise.

Your doctor will check your symptoms and decide whether you need to have tests to rule out other conditions that might be causing your headaches. Tests may include:

• MRI or CT scan, which may be used to rule out tumors or bleeding in the brain.
• Lumbar puncture (also called a spinal tap), which may be done if your doctor thinks that you might have another condition such as meningitis or bleeding in the brain.
• Sedimentation rate (a blood test), which may help determine whether another condition is causing inflammation related to your headaches.

Exams and Tests

Your doctor can usually diagnose tension headaches by asking you questions about your health and lifestyle and by examining you.

It is important to distinguish tension headaches from other headaches (such as migraines) because symptoms can be similar, but treatment may vary. Usually migraine pain is felt on only one side of the head. Tension headaches usually cause pain on both sides of your head.

Your doctor may diagnose tension headaches if you have headaches with:

• Constant pain that does not throb or pulse. You usually feel the pain or pressure on both sides of your head.
• Tightness around your forehead that may feel like a “vise grip.”
• Aching pain at your temples or the back of your head and neck.

You might be sensitive to light or noise (but not both at the same time), but you will not usually feel nauseated. The pain does not get worse with activity.

Tension headaches can last any length of time from 30 minutes to 7 days. You may be diagnosed with chronic tension headaches if you have the same symptoms but have at least 15 of these headaches a month over a 6-month period.

In very rare cases, headaches can be caused by other, more serious medical conditions (such as brain tumors or aneurysms). Your doctor may order tests to rule out other causes. These tests may include:

• A lumbar puncture, a test in which your doctor uses a needle to remove a small amount of fluid from your spinal canal. The fluid is then looked at for signs of infection.
• An electroencephalogram (EEG), a test that measures and records the electrical activity of your brain by using sensors (electrodes) attached to your head and connected by wires to a computer.
• An MRI scan of your brain, a test that uses a magnetic field and pulses of radio wave energy to provide pictures of your brain.
• A CT scan of your head, a test in which a scanner directs a series of X-ray pulses through your head. This produces detailed pictures of structures inside the head.

Parents may become very concerned about headaches in children and feel that extensive testing is needed to rule out serious causes. But doctors often can evaluate children’s headaches without using imaging tests. Children who have headaches will sometimes be monitored for 6 months or longer from the time of their first headache.

Estate planning also helps to protect assets and ensure that your money will be used as you want. While a will controls what happens to your assets upon your death (thus avoiding the cost of probate), be certain to get a durable power of attorney and living will as well. A durable power of attorney gives someone the authority to act for you, while a living will allows you to give instructions regarding life-sustaining treatments. Without them, your family may not be able to make financial or medical decisions on your behalf, should you not be in a position to do so.

While preparing your will, also inventory and list major assets, including bank accounts, investments, property and insurance policies. Make sure that your family knows where to find that information should you become incapacitated.

For many people, their chief asset may be their home. Indeed, many older people have quite a bit of equity in their home. If that’s true for you, you may want to consider a reverse mortgage. Available through public and private programs to people 62 and older, reverse mortgages can supplement retirement savings or cover unexpected medical costs while allowing you to remain in your home.

Reverse Mortgages Q&A

What is a reverse mortgage? Reverse mortgages allow homeowners to turn the equity in their homes into cash without the burden of monthly loan payments. As a rule, the reverse mortgage must be the primary debt against a house. Most borrowers pay off an existing home mortgage with a lump sum advance from a reverse mortgage. Homeowners still are responsible for property taxes, home insurance and repairs.

How do they work? No payments are due as long as your home is your primary residence. However, when the last surviving borrower sells the home, permanently moves out or dies, the cash advance must be repaid with interest. You or your estate can keep whatever amount is left over if that amount is less than the home’s value. However, you can never owe more than the home’s worth when the loan is repaid.

How much money can I get? Generally, the more valuable your home and the older you are, the more you can borrow. Pay out options usually include monthly payments and/or a line of credit.

What are some of the reverse mortgages available?

The Home Equity Conversion Mortgage (HECM) is the most popular of all reverse mortgages and is insured by the Federal Housing Administration. The FHA limits loan amounts, but also restricts loan costs. HECMs are available to homeowners 62 and older, and the money can be used for any purpose.

Deferred Payment Loans are low-cost loans offered by many state and local governments, usually for repairing or improving a home. They go by a variety of names; contact your state housing finance agency to find out if one is available in your area. They are generally available to homeowners with low to moderate incomes.

The Fannie Mae Home Keeper® reverse mortgages are available to homeowners with houses with higher property values than those covered by HECMs as well as condo owners.

Other sources of information:

List of FHA approved lenders: 800/569-4287

Fannie Mae: Call 800/732-6643 to get a copy of A Consumers Guide to Reverse Mortgage Options

National Reverse Mortgage Lenders Association: http://www.reversemortgage.org/

Long-Term Care Insurance: Some Things To Consider

• Is the insurer financially stable and likely to still be around 20 or 30 years from now?
• Will you still be able to afford the premiums in your later years?
• What are the conditions for qualifying for benefits?
• Does the policy include a range of options, including home health care and assisted living?
• Does it include an option for inflation protection (to help pay for the increased cost of care in future)?
• If you buy a plan through your employer, can you continue it if you leave the company?
• Is it possible to buy coverage for your parents through your employer’s plan?

Financial Help for Seniors

If you are helping a parent or relative with their financial affairs, here are some other resources that might be of help:

Medicare: A government health insurance plan for individuals age 65 and over. It is available to U.S. citizens or permanent residents if they, or their spouses, have worked in a Medicare-covered position for at least 10 years.

Medicaid: A health insurance plan for low-income individuals 65 and older (among others) with few resources.

Supplemental Social Security (SSI): Individuals 65 and older with limited income and limited resources are eligible for monthly cash benefits. In 2004, eligible recipients’ cash and savings could not exceed $2,000 ($3,000 for a couple).

The Social Security Administration offers a quick screening tool online at http://best.ssa.gov/ that can help determine eligibility for SSI or other benefits.

Property Tax Deferral: Many state and local governments have programs that provide loans to seniors with low or moderate incomes to pay their property taxes. No repayment is required for as long as they remain in their homes

What is an advance directive?

An advance directive is a form that you fill out to describe the kinds of medical care you want to have if something happens to you and you can’t speak for yourself. It tells your family and your doctor what to do if you’re badly hurt or have a serious illness that keeps you from saying what you want. An advance directive can also be a talk you have with your family and your doctor about the kinds of care you want to have.

What are the different types?

There are two main types of advance directives:

• A living will tells your family and your doctor what kinds of treatment you want to receive as you near the end of your life and if you can no longer speak for yourself. A living will is also called a treatment directive.
• A medical power of attorney lets you name a person to make treatment decisions for you when you can’t speak for yourself. This person is called a health care agent or health care proxy.

As long as you can still make your own decisions, your advance directive won’t be used. You can stop or say “no” to treatment at any time.

How do you write an advance directive?

As you prepare your advance directive, you’ll need to follow these four important steps:

1. Get the living will and medical power of attorney forms for your state. Forms are different in each state, so be sure to get the right ones for where you live.
2. Choose your health care agent. This should be a person you trust to make decisions for you.
3. Fill out the forms, and have them witnessed as your state requires.
4. Give copies to your family, your doctor, and your health care agent.

You can get the forms in a doctor’s office, hospital, law office, state or local office for the aging, senior center, or nursing home. You can also get them online at www.caringinfo.org or by calling 1-800-658-8898.

When you write your advance directive, think about the kinds of treatments that you do or don’t want to receive if you get seriously hurt or ill.

Consider whether you want to:

• Receive cardiopulmonary resuscitation (CPR) if your heart stops.
• Be on a machine that pumps air into your lungs through a tube if you can’t breathe on your own.
• Be on a machine that cleans your blood if your kidneys stop working.
• Be fed or get fluids through a tube if you can’t eat or drink.
• Take medicines to treat serious infections.

These are tough choices to make, but you don’t have to make them alone. Take your time. Share your questions or concerns about what to include in your advance directive with your doctor or nurse, your lawyer, your family, or a friend.

What if you want to change what is in your advance directive?

You can change or cancel your advance directive at any time. Just fill out new forms and get rid of your existing forms. Or you can just let your family, your doctor, and your health care agent know about the change. If you change or create new forms, tell everyone. Don’t just cross out or add new information unless it’s only to change your address or phone number.

Basic Types of Advance Directives

An advance directive is a legal form that describes the kinds of medical care you want to receive if something happens to you and you can’t speak for yourself. It tells your family and your doctor what to do if you’re badly hurt or have a serious illness that keeps you from saying what you want.

The two main types of advance directives are a living will and a medical power of attorney:

Living will

A living will makes clear the kinds of medical care you want to receive if you get seriously hurt or ill and can’t make your own decisions. It describes your choices for care and how you want them carried out if you’re near the end of your life or are in the hospital with a serious illness. If you get better and can speak for yourself again, you can stop or say “no” to treatment at any time. If you have a living will, your choices will be honored. A living will is also called a treatment directive.

Medical power of attorney

A medical power of attorney lets you name a person to make treatment decisions for you when you can’t speak for yourself. This person is called a health care agent or health care proxy. Some states may limit what your health care agent can decide for you. In a few states, he or she can speak for you right away and at any time that you don’t want to make choices for yourself. He or she can also use your living will and what he or she knows about you to help guide your care.

When you choose a health care agent, select a person you trust to make medical decisions for you. For more information, see the topic Choosing a Health Care Agent.

As long as you can still make your own decisions, your advance directive won’t be used. You can change or cancel it at any time. Your health care agent will only make choices for you if you can’t or don’t want to decide for yourself.

Prevention

You may be able to prevent the frequency and severity of tension headaches by reducing muscle tension and by identifying and avoiding the triggers, such as stress, anxiety, fatigue, hunger, anger, poor posture, or overexertion.

If you have tension headaches related to muscle tension in your neck, shoulders, and upper back, pay attention to your posture and position during your daily activities.

What do you do when you have a headache this big? Before reaching for a pill that dulls the pain without addressing the problem, look to the cause. The causes of headaches are many, but the root cause can almost always be traced back to lifestyle. Read on to find out how to stop a headache in its tracks!

Common Causes of Headaches
Something in your life is creating an adverse environment that causes a headache. For instance, most people are familiar with the occasional headache that comes from a cold, staying up too late, or drinking too much. Other common culprits include sinus problems, muscle tension, eyestrain, stress, jaw clenching, a virus, allergies, poor eating habits, and a muscle injury in the neck and back. Some women may experience headaches due to a hormonal imbalance.

The Food Factor
What we eat on a regular basis affects the energy flow in our body. Proper eating habits can help maintain a good flow of energy and blood to the head, preventing headaches. Eat frequent smaller meals and choose wholesome foods, with no preservatives, additives, or artificial compounds.

For headache relief, eat more: whole grains, fiber-rich foods, green leafy vegetables, parsley, chrysanthemum flowers, mint, green tea, onions, ginger, pearl barley, carrots, prunes, buckwheat, peach kernels, and almonds.

Stay away from: alcohol, chocolate, MSG, nitrates, sulfites, sugar, salt, caffeine, and oily, greasy, or fried foods. Consider that caffeine, because it affects your blood vessels, can provide instant relief from a migraine headache. But be cautioned that regular use will make you dependent, meaning when you don’t have it, the withdrawal will give you a painful headache! Do not eat late at night, while on the run, or under stress. Spicy, stimulating foods, and heavy starchy foods should also be avoided.

Remedies for Relief
Here are some remedies and suggestions to help you tame the pain:

• Make fresh carrot juice. Drink a glass of carrot juice every 4 hours until your headache subsides.

• Prepare a compress. Put 5 drops of lavender essential oil in 1 cup of warm water. Soak a towel in the water and then wring it dry. Place it on your forehead and/or upper neck as a compress during a headache.

• Try making this herbal tea: Boil 2 tablespoons each of chrysanthemum flowers, cassia seeds, and mint in 4 cups of water for 15 minutes. Drink 3 cups a day until the headache subsides. These herbs will help clear the sinuses and reduce head pressure. Other herbs that may prevent or temporarily relieve headaches include feverfew, peppermint, wintergreen, chamomile, and passionflower.

• Regularly stretch your neck and back muscles and pay attention to proper posture and ergonomic positioning during work and play to avoid tension headaches.

• Nip your headache in the bud before it starts with a gentle walk. Taking a walk in fresh air will help stimulate blood flow and increase the flow of oxygen to the head. So when you feel a headache coming on, step outdoors and go for a 10-minute walk, breathing deeply and vigorously.

• Headaches can typically be prevented by relaxation and stress-releasing techniques like meditation and tai chi. Practice these daily to maintain a healthy lifestyle, free from headaches. And please note that vigorous exercise during a headache episode is not recommended because it can worsen the condition.

Take note: When you experience severe, debilitating headaches that don’t respond to over the counter medication, or wake up in the middle of the night with excruciating head pain, visit your physician or the emergency room immediately.

I hope this article finds you free from future headaches! I invite you to visit often and share your own personal health and longevity tips with me.

May you live long, live strong, and live happy!

The clothes we wear and the way we keep them clean can actually shorten our life span. What role is fashion playing in your longevity plans?

In the United States, dyes containing benzidine – a substance that is easily absorbed through the skin – are no longer used because they are so highly carcinogenic.

Most of the clothing that we buy today is imported from other countries that in many cases do contain these dyes. Additionally, let’s take a look at “no-iron” cotton fabrics.

These are treated with formaldehyde resin, the fumes of which can cause allergies, asthma, cough, fatigue, headaches, restless sleep, and skin rash. Your best bet for good health is to wear naturally dyed cotton fabric.

Hang Toxins Out to Dry
Traditional dry cleaning makes use of a chemical solvent, called perchloroethylene, to remove stains. The chemical residue of this solvent is toxic to humans; in fact, many people experience such adverse reactions from dry-cleaned clothing as dizziness, headache, sinus congestion, and shortness of breath.

Perchloroethylene has also been found to cause cancer in animals. Minimize your exposure to chemicals by airing out your dry-cleaned garments for at least 24 hours before putting them away in closets or drawers. Another better option is to seek out dry cleaners that use only organic, nonchemical cleaning methods.

Clean of Chemicals?
Laundry methods are not totally free of health risks, either. When we clean our clothing with chlorinated laundry detergent and bleach, inhalation can irritate or damage the lungs and upper airway.

Your healthy alternative is to launder your clothes in baking soda or natural detergent. Brighten those whites with borax or nonchlorine bleach.  When you stick to the natural stuff, you will not only get truly clean clothes but also help save the environment from degradation.

Keep Moths Out Naturally
Moths spell bad news for your clothes and nothing is more aggravating than finding out that there is a moth hole in your favorite sweater.

Tempting as it might be, don’t use mothballs. They contain a benzene compound that can cause cancer. Instead, opt for the natural alternatives: cedar balls or panels and dried citronella, lavender, marigold, and pennyroyal that can be purchased in herb shops. Another option is to place your clothing in vacuum-sealed bags for storage.

A Caution About All that Glitters
When your favorite silver ring is tarnished, before reaching for your jewelry cleaner, consider this: one of the substances commonly found in these cleaners is cyanide – the potent poison that can affect you negatively through fume inhalation and skin contact.

Though a seemingly small amount of toxicity, these exposures add up, compromising our health over the long term. Some simple nontoxic alternatives for jewelry cleaning can be found around the house. To clean silver, line a bowl (preferably glass) with aluminum foil and fill with three cups of hot water mixed with two tablespoons of cream of tartar, readily available in the spice or baking section of your supermarket.

Once this mixture dissolves, soak your silver jewelry for one hour and then rinse with water. For gold, use baking soda or toothpaste with a soft cloth.

I hope this blog finds you fashionably healthy! I invite you to visit often and share your own personal health and longevity tips with me.

May you live long, live strong, and live happy!