Last week, while singing in my community choir, I felt a terrible vice-like pain in the back of my head. After a while it diminished to a pain on the right side. side of my head. Could it be a trapped nerve?
Dr. Ellie Cannon responds: This sounds like a splitting headache: a very intense, sudden pain that is often described as feeling like you’ve been punched in the back of the head. It may be normal to experience other symptoms in addition, such as nausea, drowsiness, neck pain, or dizziness.
Some people will have thunderclap headaches that have no particular underlying cause, although this is rare.
The headache is usually worse at first and may take an hour to go away. But often some pain can persist for a week or more.
Sometimes, but not always, it is the result of bleeding in the brain that may come from an aneurysm. This can be life-threatening.
It may be a sign of high blood pressure or the result of a sudden narrowing of blood vessels in the brain called vasoconstriction. This can be caused by exertion or stress, but also by straining, coughing or sneezing.
Some people will have thunderclap headaches that have no particular underlying cause, although this is rare. They may notice a trigger such as cough, exercise, or sexual activity.
There are case reports in the scientific literature of people who had more unusual headache triggers, including singing.
Anyone experiencing significant headaches should seek medical help for urgent evaluation and scans. This is particularly important for people with new or sudden headaches, and those that can be described as the worst of your life.
I am 88 years old and have just been diagnosed with cancer in several parts of my body. I have no pain and I have been given morphine to help with the annoying cough and I take it before going to bed.
The instructions say “avoid alcohol,” but I miss my glass of wine at night. Could I still afford this privilege?
Alcohol with morphine should be avoided because it worsens side effects and contributes to drowsiness and confusion, writes Dr. Ellie Cannon.
Dr. Ellie answers: Morphine is an opioid medication that is prescribed for palliative care, when the goal is not to cure the cancer, but to relieve symptoms and improve the patient’s quality of life as much as possible. It also suppresses the cough reflex, similar to codeine linctus that we give for the same reason.
It is true that alcohol should be avoided with morphine because it worsens side effects and contributes to drowsiness and confusion. This can be dangerous when people take a lot of morphine or drink a lot of alcohol.
But having a small glass of wine a few hours before taking morphine should not be a problem.
It may cause increased drowsiness, but in someone taking morphine before bed, this is unlikely to be a problem anyway. The benefits of enjoying wine seem paramount here.
For a test, you can first try half a glass of wine.
I suffered three urine infections in the last six months and ended up taking antibiotics each time. Someone suggested I try a medicine called Hiprex and I would like to know what you think.
I am 68 years old and also suffer from IBS.
Dr. Ellie answers: In a postmenopausal woman who suffers from recurrent urinary tract infections (UTIs), the most important thing is to verify that each infection has been verified with a laboratory result.
This is to ensure that infections are treated with the correct antibiotic every time, as some people have resistant infections and may be given the wrong medicine.
But it is also vital as sometimes the symptoms are assumed or labeled as urine infections when in fact they are not.
They have symptoms that mimic an infection, but no infection is seen.
This is incredibly important because recurrent urinary symptoms can also be a sign of other conditions, including, rarely, ovarian cancer and more common diseases like thrush. Hiprex is not an antibiotic but a medication used to prevent urinary tract infections.
Scientific evidence of its value has been growing, and for anyone with recurrent UTIs, it’s worth asking your doctor for a test.
Antibiotics are also used to prevent urinary tract infections and a nightly dose is another option.
UTIs that occur around menopause may be related to a decrease in the hormone estrogen.
The hormone is important for the bladder and urethra, as well as the vagina, and a lack of estrogen can sometimes be a cause of recurrent urinary symptoms in women. This idea can be tested by trying an estrogen cream, which is used vaginally and only has local effects in the pelvic area.
You can also purchase a supplement called D-mannose, which is worth trying when you’re not trying another remedy.
Take it every day regularly for a month or two to see if it helps.
My concern about the rise of Ozempic
I spent much of last week talking to patients and on TV about the so-called “miracle weight loss soap” Ozempic.
Interest arose after news that the drug reduced the risk of heart attacks even if people taking it were not that overweight to begin with. This is important, because we had previously thought that the benefits came from losing weight.
Are good news. But I can’t help but feel worried.
Obesity exists because of people eating huge portions, junk food specials, and a general lack of physical activity that starts at school age and gets worse and worse.
Instead of the solution being to address any of the causes, we are prepared to solve this with expensive medications. It all seems a bit upside down to me.
Do you have any questions for Dr. Ellie Cannon? Email DrEllie@mailonsunday.co.uk
Dr. Cannon cannot engage in personal correspondence and her responses should be taken in a general context.