Category Archives: Health & Wellness
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.
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.
Flu, Covid-19, RSV: Which vaccines do you need?
By: RAFEENA BACCHUS, M.D.
Each year, the influenza (flu) virus sickens millions of Americans. This fall we expect two other respiratory illnesses — Covid-19 and RSV — to surge around the same time.
Fortunately, safe and effective vaccines are available for the three viruses, and your doctor may recommend you get vaccinated against all three. Here’s what you need to know.
Flu
With symptoms like fever, chills, body aches and fatigue, the flu makes us feel lousy. It can be very serious for older adults, young children and people with chronic illnesses. The flu virus continues to mutate new strains, so the vaccine typically protects against several types at once. The CDC recommends the vaccine for everyone 6 months and older, but it is especially important for adults 65+, children under 5, and those with weak immune systems.
Coronavirus
As we know, the coronavirus can mutate quickly, introducing new and risky variants. The dominant strain in the U.S. is currently EG.5, which spreads easily and causes symptoms similar to earlier versions, such as runny nose, fever, cough, headache, fatigue and sore throat. A new vaccine scheduled for release this fall will likely protect against EG.5 and other strains of the virus. The CDC recommends that everyone 6 months and older get the Covid-19 vaccine.
RSV
RSV (respiratory syncytial virus) usually produces mild cold-like symptoms, but it is increasingly recognized as a threat for young children and seniors with certain chronic health conditions. The FDA recently approved the first RSV vaccines for adults 60+ and pregnant women 32-36 weeks pregnant (to give their unborn children immunity). There is also a long-acting antibody treatment for infants up to 8 months of age and up to 19 months of age that are at high risk for severe infection.
Can you test positive for 3 viruses at once?
Flu, coronavirus and RSV are all highly infectious viruses, and in past years we’ve seen cases of people infected by two of them at once. It is even possible to catch all three at the same time. Hospitalization is often required for those suffering from these co-infections due to their more serious cases of illness. As you would expect, this is especially risky for young children, older adults, and people with chronic health conditions.
Which vaccines should you get?
The CDC recommends everyone 6 months and older to get the flu and Covid-19 shots as soon as possible this fall. The RSV vaccines are approved for people 60 years and older and the CDC suggests people 60+ with conditions such as congestive heart failure, coronary artery disease, COPD, asthma, diabetes, chronic kidney disease, immunocompromised conditions, and those that are long-term care residents, consult with their doctors.
Most of us can safely get the flu and Covid-19 shots at the same time. Since the RSV vaccine is new, health experts recommend getting it separately, but older adults in poor health may be able to get all three shots at once.
To schedule vaccinations, or if you have questions about them, contact your MPCP healthcare provider.
Dr. Rafeena Bacchus sees patients at MPCP’s Columbia office. She received her medical degree from SUNY at the Buffalo School of Medicine and completed her residency program in Internal Medicine at the University of Maryland. She is certified by the American Board of Internal Medicine.
10 ‘Healthy’ Foods That Aren’t Good for You
By: OLADUNNI FILANI, MD
Even though food companies market many foods and beverages as “healthy,” some may not be nutritious choices. Many are packed with sugar, salt and other ingredients that can impact your health.
Here are 10 popular foods widely viewed as “healthy” that are actually not good for you.
- Veggie chips: “Veggie” may be in the name, but that doesn’t make them healthy. Many veggie chips are nutritionally similar to potato chips because they are highly processed, deep fried in oil and heavily salted. Also, some are made from potato flour with vegetable powder added for flavor, so you’re basically getting a potato chip.
If you’re craving a veggie crunch, look for those that are baked instead of fried and have less sodium.
- Fruit juices: All fruit juices are high in sugar. An eight-ounce serving of juice contains about eight teaspoons of sugar, the same as a soda. Fruit juices have “natural” sugar, but that doesn’t make it healthier than the sugar in soda.
On the plus side, fruit juice offers some nutrients. Studies show drinking no more than five ounces a day is linked to a lower risk of heart disease and stroke. So a small amount of fruit juice is okay, but a lot can give you too much sugar and contribute to poor health.
- Plant-based meats: Plant-based meats are promoted as being healthier than real meat, but that’s not always the case. They are often highly processed and high in saturated fats and sodium, and they usually don’t contain the same protein levels as lean meat, fish, poultry and eggs.
- Granola and granola bars: Some granolas and granola bars are very nutritious, but many are loaded with extra sugar and are high in calories. For example, a 2/3-cup serving of Nature Valley Oats and Dark Chocolate Protein Granola contains 7 grams of added sugar and 290 calories, while Quaker Chewy Yogurt Granola Bars include 10 grams of added sugar per bar.
If you like granola but want to avoid unhealthy store brands, try making your own at home. You can use nutritious ingredients like nuts and oats and add sweetness with dried fruit.
- Flavored yogurts: Don’t let the small cartons fool you, flavored and “fruit on the bottom” yogurts can pack a lot of sugar in one serving. For example, a 5.3-ounce container of Dannon Strawberry Fruit on the Bottom yogurt contains a hefty 15 grams of added sugar. Yogurts that have candy toppings and “flip-style” yogurts can have even more.
Instead of choosing sweetened yogurt, try topping unsweetened yogurt with fresh fruit for a bit of natural sweetness.
- Protein drinks and bars: Just because a product is high in protein doesn’t make it healthy. These items are often loaded with extra sugar, sodium and artificial ingredients.
If you do want extra protein in your diet, you can get it by eating more protein-rich foods, such as fish, eggs and beans.
- Sports drinks and energy beverages: Advertising for these products say they boost energy and athletic performance, but they can also be high in added sugar and caffeine. A 20-ounce bottle of Fruit Punch Gatorade contains 34 grams of added sugar, and the Monster Energy drink has 54 grams per 16-ounce can. (This is more than your recommended daily amount of sugar!)
Most people who perform moderate exercise or normal daily activity don’t need sports drinks to stay hydrated. Plain water works just fine.
- Gluten-free snacks: People with gluten-related disorders need to avoid gluten — a protein found in wheat and several other grains. But nutritionists agree that for most of us eating foods with gluten is fine and there is no health benefit to cutting them out of your diet.
If you go gluten-free when you don’t need to, there’s a risk you could miss out on nutritious whole grains, fiber and micronutrients. Also, some processed gluten-free snacks tend to be lower in protein, fiber and vitamins and minerals than other snacks, and may have as much sugar and calories.
- Premade smoothies: Homemade smoothies can be a tasty way to get more fruits and vegetables into your diet. However, premade smoothies and those from some chains contain large amounts of calories and sugar. If you buy a smoothie, be sure to check the ingredients first and avoid the unhealthy ones.
- Some plant-based milks: Plant-based milks — including those made from almonds, coconut, rice, and soy — can be an excellent alternative to dairy products. However, many plant milks add sugar to improve their taste. For example, original Almond Breeze almond milk contains 7 grams of added sugar per 1-cup serving.
It’s a good idea to choose unsweetened plant milks if you want to limit added sugar. So before you buy a product, read the nutrition label and look for those with less sugar.
Dr. Filani cares for patients in MPCP’s Bowie office. He is certified by the American Board of Family Medicine and completed his fellowship in Primary Care Sports Medicine at the University of Maryland.
Move Over Lyme Disease, Here Comes Babesiosis
By: TIMOTHY KLEPPER, M.D.
Tick season is here, and we’re hearing the usual warnings about Lyme disease. But due to a mild winter and spreading tick population, there’s a new threat to watch out for: babesiosis (bah-bee-see-oh-sis).
Both Lyme disease and babesiosis are parasitic diseases carried by deer ticks, also called black-legged ticks. The CDC reports a significant increase in reported cases of both this year in the eastern U.S.
Lyme disease and babesiosis differ in their symptoms and health risks. Here’s a side-by-side comparison of the two, and what you need to look out for.
| Babesiosis | Lyme disease | |
| Likelihood of infection | Low, especially if tick is attached for less than 36 hours | Low, especially if tick is attached for less than 36 hours |
| How soon symptoms start | 1-4 weeks after tick bite | 3-30 days after tick bite |
| Symptoms | Mild to severe flu-like symptoms: fever, chills, sweating, loss of appetite, nausea, tiredness
In severe infections: yellowish skin or eyes, pale skin, dark urine, shortness of breath, nausea and vomiting, abdominal pain, neck stiffness, sudden mood changes |
Circular bulls-eye rash around the tick bite
Early infection: flu-like symptoms: tiredness, muscle pain, joint pain, headaches, fever, chills |
| Risks | Can be life-threatening, especially if you have a weak immune system or don’t have a working spleen. May cause anemia, enlarged spleen, fluid buildup in your lungs, blood clotting problems, kidney or liver failure | Late infection: neck stiffness, pain and swelling in your joints, numbness or pain in your limbs, memory problems, difficulty concentrating, heart problems. Usually not life-threatening |
| When you should see a doctor | If you were bitten by a tick and have flu-like symptoms, especially if you have a weak immune system | If you were bitten by a tick and have an expanding red rash around the bite or have flu-like symptoms |
| Usual treatment | Combination of anti-parasitics and antibiotics Antibiotics | Antibiotics |
How to prevent tick bites
The best way to avoid getting sick with babesiosis and Lyme disease is to not get bitten. Remember the ABCs of prevention:
“A” stands for avoid. You want to avoid areas ticks are found, such as where there are low bushes, leaf litter and tall grass.
“B” stands for bug spray. Use it when you’re outdoors and think you’re going to be exposed to tick bites. The CDC recommends a bug spray that contains either DEET 30% or picaridin. You also could use a spray that has oil of lemon eucalyptus in it.
“C” stands for cover up. Wear protective clothing. If you have clothing over your skin, ticks won’t be able to bite you.
What to do if you’re bitten by a tick
Use tweezers to grasp the tick as close to your skin as possible, then pull the tick off with steady pressure. Then wash your hands and the area of the bite with soap and water. Sometimes, the mouthparts of the tick will break off and stay in the skin. If you can remove them easily, use the tweezers to pull them out. If you can’t remove them easily, just let the skin heal. Your body will break down the remaining mouth parts over time.
Remember, your chances of getting a tick disease are much lower if you remove the tick within 36 hours of being bitten.
Dr. Klepper is a Maryland Primary Care Physicians, LLC partner and is certified by the American Board of Family Medicine. He cares for patients in the Queenstown office.
