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Facial Flushing and Carcinoid Syndrome

Facial flushing is a physiological response that can be attributed to many causes. For example, alcohol flush reaction, fever, exercise, emotions, inflammation, allergies, or hormonal changes such as menopause are just some of the reasons behind a markedly red face and other areas of the body.

 mheim3011 / iStock / Getty Images

In rare cases, facial flushing can be a sign of a much bigger problem, including being a symptom of carcinoid syndrome. Carcinoid syndrome is a group of signs and symptoms that are associated with tumors of the enterochromaffin cells, a type of neuroendocrine cell found in the gastrointestinal tract.

When rare cancerous tumors called carcinoid tumors secrete certain chemicals and hormones into your bloodstream, they cause a variety of symptoms. These cancerous tumors can be found in the intestines, appendix, rectum, lungs, stomach, pancreas, and thyroid.

Facial flushing caused by carcinoid syndrome varies with the location of the tumor.

Carcinoid Syndrome Symptoms

Carcinoid syndrome typically occurs in people who have advanced carcinoid tumors. The signs and symptoms of carcinoid syndrome will be different depending on the chemicals secreted into your bloodstream. Some of the most common signs and symptoms include:

  • Facial flushing: Your skin may feel hot and change color when experiencing facial flushing, which can be triggered by stress, exercise, or alcohol, or have no obvious reason at all. Your neck and upper chest may also be involved and this symptom can last from a few minutes to a few hours or longer.
  • Skin lesions on the face: Welts, spider-like veins, along with purplish discolored areas, may appear on the nose and upper lip.
  • Diarrhea: Abdominal cramps, along with frequent visits to the bathroom, may occur in individuals with carcinoid syndrome.
  • Breathing difficulties: Wheezing and shortness of breath may occur while facial flushing is happening.
  • Heart abnormalities: A rapid heartbeat or heart valve problems could be a sign of carcinoid syndrome.


Physiologically speaking, flushing is caused by increased blood flow under the skin. When blood vessels widen, this is known as vasodilation. It results from relaxation of smooth muscle cells within the blood vessel walls.

Areas such as the face, ears, neck, upper chest, and upper arms have countless blood vessels under the skin, and a surge in blood flow can cause these blood vessels to widen and fill with blood.

In the case of carcinoid syndrome, the flushing is caused by the sudden release of the vasodilator chemicals produced by the enterochromaffin cells. Some of these chemicals are serotonin, 5-hydroxytryptamine (5-HT), substance P, histamine, and catecholamines.

Carcinoid syndrome is diagnosed by a specialized urine test that measures a chemical called 5-HIAA.


The facial flushing of carcinoid syndrome is treated by removal of the tumor and administering a medication called octreotide aimed at reducing the secretion of the vasodilating chemicals.

Traditional antihistamines and h3-blockers like cimetidine and ranitidine used to treat acid reflux have also been effective in treating the facial flushing of carcinoid syndrome.

Treatment for carcinoid syndrome usually involves treating the underlying cancer. However, because most carcinoid tumors don’t cause carcinoid syndrome until they’re advanced, a cure may not be possible. In those cases, medications may relieve your carcinoid syndrome symptoms and make you more comfortable.

Facial Problems, Non-Injury | HealthLink BC

Do you have a facial problem?

How old are you?

Less than 4 years

Less than 4 years

4 years or older

4 years or older

Are you male or female?

Why do we ask this question?

The medical assessment of symptoms is based on the body parts you have.

  • If you are transgender or non-binary, choose the sex that matches the body parts (such as ovaries, testes, prostate, breasts, penis, or vagina) you now have in the area where you are having symptoms.
  • If your symptoms aren’t related to those organs, you can choose the gender you identify with.
  • If you have some organs of both sexes, you may need to go through this triage tool twice (once as “male” and once as “female”). This will make sure that the tool asks the right questions for you.

Have you had a head injury in the past 24 hours?


Head injury in past 24 hours


Head injury in past 24 hours

Have you had an injury to your face in the past 2 weeks?


Facial injury in the past 2 weeks


Facial injury in the past 2 weeks

Are you having trouble breathing (more than a stuffy nose)?


Difficulty breathing more than a stuffy nose


Difficulty breathing more than a stuffy nose

Could you be having a severe allergic reaction?

This is more likely if you have had a bad reaction to something in the past.


Possible severe allergic reaction (anaphylaxis)


Possible severe allergic reaction (anaphylaxis)

Could you be having symptoms of a heart attack?

In some cases, a heart attack may cause a strange feeling in part of the face, such as the jaw.


Symptoms of heart attack


Symptoms of heart attack

Have you had any new vision changes?

These could include vision loss, double vision, or new trouble seeing clearly.

Did you have a sudden loss of vision?

A loss of vision means that you cannot see out of the eye or out of some part of the eye. The vision in that area is gone.

Do you still have vision loss?


Vision loss still present


Vision loss still present

Did the vision loss occur within the past day?


Vision loss occurred in the past day


Vision loss occurred in the past day

Have you had any changes in feeling or movement in your face?

Changes could include weakness or loss of movement in part of the face, numbness or tingling, facial drooping, or trouble closing an eye.


Changes in feeling or movement in face


Changes in feeling or movement in face

Do you have blisters on your forehead, eyelid, or nose?

Blisters in this area may be a sign of shingles and may cause serious eye problems.

Is there any swelling in your face?

Was the swelling sudden?


Facial swelling was sudden


Facial swelling was sudden

Do you think the eyelid or the skin around the eye may be infected?

Symptoms could include redness, pus, increasing pain, or a lot of swelling. (A small bump or pimple on the eyelid, called a stye, usually is not a problem.) You might also have a fever.


Symptoms of infection around eye


Symptoms of infection around eye

Do you have any pain in your face?

Do you have any eye pain?

Have you had facial pain for:

Less than 1 full day (24 hours)?

Pain for less than 24 hours

1 day to 1 week?

Pain for 1 day to 1 week

More than 1 week?

Pain for more than 1 week

Do you think you may have a fever?

Are there red streaks leading away from the area or pus draining from it?

Do you have diabetes, a weakened immune system, or any surgical hardware in the area?

“Hardware” in the facial area includes things like cochlear implants or any plates under the skin, such as those used if the bones in the face are broken.


Diabetes, immune problems, or surgical hardware in affected area


Diabetes, immune problems, or surgical hardware in affected area

Have you had thick, yellow discharge from your nose for more than 5 days that is not getting better?

This may mean you have a sinus infection.


Nasal discharge more than 5 days not getting better


Nasal discharge more than 5 days not getting better

Do you have a rash or any blisters on your face?


Rash or blisters on face


Rash or blisters on face

Do you think that a medicine may be causing the facial problem?

Think about whether the symptoms started soon after you began using a new medicine or a higher dose of a medicine.


Medicine may be causing facial symptoms


Medicine may be causing facial symptoms

Have your symptoms lasted longer than 1 week?


Symptoms have lasted longer than 1 week


Symptoms have lasted longer than 1 week

Many things can affect how your body responds to a symptom and what kind of care you may need. These include:

  • Your age. Babies and older adults tend to get sicker quicker.
  • Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
  • Medicines you take. Certain medicines and natural health products can cause symptoms or make them worse.
  • Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
  • Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.

Try Home Treatment

You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.

  • Try home treatment to relieve the symptoms.
  • Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.

Symptoms of difficulty breathing can range from mild to severe. For example:

  • You may feel a little out of breath but still be able to talk (mild difficulty breathing), or you may be so out of breath that you cannot talk at all (severe difficulty breathing).
  • It may be getting hard to breathe with activity (mild difficulty breathing), or you may have to work very hard to breathe even when you’re at rest (severe difficulty breathing).

Severe trouble breathing means:

  • You cannot talk at all.
  • You have to work very hard to breathe.
  • You feel like you can’t get enough air.
  • You do not feel alert or cannot think clearly.

Moderate trouble breathing means:

  • It’s hard to talk in full sentences.
  • It’s hard to breathe with activity.

Mild trouble breathing means:

  • You feel a little out of breath but can still talk.
  • It’s becoming hard to breathe with activity.

Severe trouble breathing means:

  • The child cannot eat or talk because he or she is breathing so hard.
  • The child’s nostrils are flaring and the belly is moving in and out with every breath.
  • The child seems to be tiring out.
  • The child seems very sleepy or confused.

Moderate trouble breathing means:

  • The child is breathing a lot faster than usual.
  • The child has to take breaks from eating or talking to breathe.
  • The nostrils flare or the belly moves in and out at times when the child breathes.

Mild trouble breathing means:

  • The child is breathing a little faster than usual.
  • The child seems a little out of breath but can still eat or talk.

Pain in adults and older children

  • Severe pain (8 to 10): The pain is so bad that you can’t stand it for more than a few hours, can’t sleep, and can’t do anything else except focus on the pain.
  • Moderate pain (5 to 7): The pain is bad enough to disrupt your normal activities and your sleep, but you can tolerate it for hours or days. Moderate can also mean pain that comes and goes even if it’s severe when it’s there.
  • Mild pain (1 to 4): You notice the pain, but it is not bad enough to disrupt your sleep or activities.

Pain in children under 3 years

It can be hard to tell how much pain a baby or toddler is in.

  • Severe pain (8 to 10): The pain is so bad that the baby cannot sleep, cannot get comfortable, and cries constantly no matter what you do. The baby may kick, make fists, or grimace.
  • Moderate pain (5 to 7): The baby is very fussy, clings to you a lot, and may have trouble sleeping but responds when you try to comfort him or her.
  • Mild pain (1 to 4): The baby is a little fussy and clings to you a little but responds when you try to comfort him or her.

Symptoms of infection may include:

  • Increased pain, swelling, warmth, or redness in or around the area.
  • Red streaks leading from the area.
  • Pus draining from the area.
  • A fever.

Symptoms of a severe allergic reaction can start within minutes of eating or being exposed to an allergen. While symptoms usually occur within 2 hours, in rare cases the time frame can vary up to several hours after exposure. Do not ignore early symptoms. When a reaction begins, it is important to respond right away.

Symptoms of a severe allergic reaction can vary from person to person. The same person can have different symptoms each time they have a severe allergic reaction. Symptoms can include any of the following:

    • Skin: hives, swelling (face, lips, tongue), itching, warmth, redness
    • Respiratory (breathing): coughing, wheezing, shortness of breath, chest pain or tightness, throat tightness, hoarse voice, nasal congestion or hay fever-like symptoms (runny, itchy nose and watery eyes, sneezing), trouble swallowing
    • Gastrointestinal (stomach): nausea, pain or cramps, vomiting, diarrhea
    • Cardiovascular (heart): paler than normal skin colour/blue colour, weak pulse, passing out, dizziness or lightheadedness, shock
    • Other: anxiety, sense of doom (the feeling that something bad is about to happen), headache, uterine cramps, metallic taste

A severe reaction can take place without hives, so make sure to look out for all of the signs of an allergic reaction.

Symptoms of a stroke may include:

  • Sudden numbness, tingling, weakness, or paralysis in your face, arm, or leg, especially on only one side of your body.
  • Sudden vision changes.
  • Sudden trouble speaking.
  • Sudden confusion or trouble understanding simple statements.
  • Sudden problems with walking or balance.
  • A sudden, severe headache that is different from past headaches.

Shock is a life-threatening condition that may quickly occur after a sudden illness or injury.

Adults and older children often have several symptoms of shock. These include:

  • Passing out (losing consciousness).
  • Feeling very dizzy or light-headed, like you may pass out.
  • Feeling very weak or having trouble standing.
  • Not feeling alert or able to think clearly. You may be confused, restless, fearful, or unable to respond to questions.

Shock is a life-threatening condition that may occur quickly after a sudden illness or injury.

Babies and young children often have several symptoms of shock. These include:

  • Passing out (losing consciousness).
  • Being very sleepy or hard to wake up.
  • Not responding when being touched or talked to.
  • Breathing much faster than usual.
  • Acting confused. The child may not know where he or she is.

Certain health conditions and medicines weaken the immune system’s ability to fight off infection and illness. Some examples in adults are:

  • Diseases such as diabetes, cancer, heart disease, and HIV/AIDS.
  • Long-term alcohol and drug problems.
  • Steroid medicines, which may be used to treat a variety of conditions.
  • Chemotherapy and radiation therapy for cancer.
  • Other medicines used to treat autoimmune disease.
  • Medicines taken after organ transplant.
  • Not having a spleen.

Symptoms of a heart attack may include:

  • Chest pain or pressure, or a strange feeling in the chest.
  • Sweating.
  • Shortness of breath.
  • Nausea or vomiting.
  • Pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly, or in one or both shoulders or arms.
  • Light-headedness or sudden weakness.
  • A fast or irregular heartbeat.

The more of these symptoms you have, the more likely it is that you’re having a heart attack. Chest pain or pressure is the most common symptom, but some people, especially women, may not notice it as much as other symptoms. You may not have chest pain at all but instead have shortness of breath, nausea, or a strange feeling in your chest or other areas.

Seek Care Today

Based on your answers, you may need care soon. The problem probably will not get better without medical care.

  • Call your doctor today to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don’t have one, seek care today.
  • If it is evening, watch the symptoms and seek care in the morning.
  • If the symptoms get worse, seek care sooner.

Seek Care Now

Based on your answers, you may need care right away. The problem is likely to get worse without medical care.

  • Call your doctor now to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don’t have one, seek care in the next hour.
  • You do not need to call an ambulance unless:
    • You cannot travel safely either by driving yourself or by having someone else drive you.
    • You are in an area where heavy traffic or other problems may slow you down.

Call 911 Now

Based on your answers, you need emergency care.

Call 911 or other emergency services now.

Sometimes people don’t want to call 911. They may think that their symptoms aren’t serious or that they can just get someone else to drive them. But based on your answers, the safest and quickest way for you to get the care you need is to call 911 for medical transport to the hospital.

Make an Appointment

Based on your answers, the problem may not improve without medical care.

  • Make an appointment to see your doctor in the next 1 to 2 weeks.
  • If appropriate, try home treatment while you are waiting for the appointment.
  • If symptoms get worse or you have any concerns, call your doctor. You may need care sooner.

Call 911 Now

Based on your answers, you need emergency care.

Call 911 or other emergency services now.

After you call 911, the operator may tell you to chew 1 adult-strength (325 mg) or 2 to 4 low-dose (81 mg) aspirin. Wait for an ambulance. Do not try to drive yourself.

Sometimes people don’t want to call 911. They may think that their symptoms aren’t serious or that they can just get someone else to drive them. But based on your answers, the safest and quickest way for you to get the care you need is to call 911 for medical transport to the hospital.

Facial Injuries

Head Injury, Age 4 and Older

Head Injury, Age 3 and Younger

Headache Danger Signs: Which Symptoms Call For Emergency Care? : Shots

Of all the aches and pains I spend my days investigating as a family doctor, none seem to be as anxiety-provoking as a headache. And that’s often true, both for patients wondering, “Could this be something dangerous?” and for clinicians trying to get to the root of pain that can be totally unexplained and yet completely debilitating.

Concerns about headaches in my practice have picked up over the past year as we’ve seen them as a symptom in acute COVID-19 infections and among long-haulers — and more recently when news broke about the (very, very few) brain clots linked to the Johnson & Johnson vaccine.

Though we’re all one Google search away from assuming a worst-case scenario when a headache strikes, the odds are overwhelmingly in our favor here. Research shows that the vast majority of headaches are what’s known medically as “primary,” meaning they’re not the result of some other underlying condition. In other words, your headache is unlikely to be caused by a serious or life-threatening problem.

Dangerous headaches also tend to have some distinctive features and patterns – and they can be hard to ignore. Here’s an overview of those red flag symptoms, and when you need same-day or emergency care:

The worst headache, in no time flat

You may have been told to be wary of a sudden headache, but just how sudden does it have to be to be a red flag? It’s a lot quicker than you’d think.

We’re talking in terms of seconds – the headache comes on fast with an intensity that stops you in your tracks, feels downright unbearable, and the pain peaks within less than a minute or so (although the headache may continue for longer). This is called a thunderclap headache, and patients tend to describe it as explosive, or “the worst headache I’ve ever had.”

Mia Minen, a neurologist and chief of headache research at NYU Langone Health, says it’s like “the snap of the finger: 10 out of 10 pain.”

That stands out from a typical headache that tends to creep up over several minutes or an hour, linger a while and get worse as time wears on. Even though other non-life-threatening headache syndromes such as migraine or cluster headaches might still usher in the same pain intensity, those tend to build more gradually or may even be preceded by an aura (sensory symptoms such as tingling or spots in your vision).

Thunderclap headaches are a sign of something serious until proven otherwise, given their link to brain bleeds — things such as ruptured aneurysms or other hemorrhages, though they can be related to other masses or lesions in the brain as well.

Do not delay medical care with a headache such as this – it’s an emergency, so call 911 or have someone help you to an emergency room. That is true for people of any age, with or without a history of headaches, and whether or not it’s accompanied by other symptoms such as vomiting or passing out.

Nervous system symptoms

My patients and their families will tell you I often belabor the same list of stroke symptoms that we all need to be ready to recognize early. If a headache accompanies one of these symptoms, don’t stop to think about the timing or severity, or really anything at all regarding that headache – just call 911.

The list of symptoms to watch for includes: abrupt weakness overall or in an arm or a leg, new numbness, changes in speech, confusion or trouble understanding and expressing thoughts clearly, facial droop or sudden trouble walking. It’s also critical you get immediate care for changes in consciousness such as difficulty waking up, being in a stupor, passing out or having a seizure.

Changes from motion

This next group of symptoms deserve same-day attention by your primary care provider. If you don’t have one, or can’t get a prompt appointment, go to an urgent care clinic.

One of the most important questions they will ask you about the headache is what’s making the pain better or worse. Take notice if the ache sharpens intensely with day-to-day movements — things such as bending over, rolling over in bed or even bearing down when you’re having a bowel movement.

And along the same lines, it may not be an ordinary headache if the pain gets much worse when lying flat and better with sitting or standing. We call that a “postural” headache, and it can be a sign of masses putting pressure on the brain or spinal cord, and has been known to happen with blood-clotting events in the brain. This type can also present as a new morning headache that’s severe and might come with vomiting.

There’s a familiar alternative to this: a headache that gets subtly worse standing up and is better lying down. This can be an indicator of dehydration (or low blood pressure, often caused by dehydration and medicines, among other things). It’s really no different than a hangover headache, though I hear complaints of this all the time from patients who admit they live off dehydrating drinks such as coffee or soda. Fortunately there’s a quick fix: Drink more water.

But if this type of pain pattern is particularly pronounced with a dramatic increase in pain when you stand up, or you can’t reasonably attribute it to being a little dehydrated (i.e., thirsty, with dry lips and scant or darker urine), it’s important to get checked out.

Stiff neck

Another sign to watch for: Along with the start of your headache, your neck feels so stiff that it’s difficult, even painful, to move. This could be a sign that something’s brewing in the brain, spinal cord or the fluid surrounding it – meningitis being the big one, and this is worth a same-day medical exam, even if there’s no other sign of infection, such as fever.

Deviation from your patterns

Don’t get too focused on the pain level of your headache, cautions Peter Goadsby, a UCLA neurologist and president of the American Headache Society.

Instead of fixating on pain severity, think about whether any feature of your headache is out of the ordinary for you. Compare the headache with others you’ve had over the course of the last few days, weeks or months.

“People have a common misconception that if it feels really bad, you’re going to die or something dreadful is always happening, and that’s just wrong,” Goadsby says. He notes common headache disorders – such as migraine, his specialty – can cause terrible pain but aren’t necessarily suspicious.

It may be helpful to ask yourself, “Is this new for me?” If the answer is yes, it’s important to follow up with your doctor.

New headache features could be a change in the timing of headache, pain in one area that never switches sides, a new or different aura beforehand or symptoms such as nausea or vomiting that you’ve never had before. And the same is true for headaches that get progressively worse over time, don’t respond to medicines, or any type of headache that keeps coming back for someone who hasn’t had trouble with them in the past.

Even so, just remember pain level can still signal an emergency if you get that thunderclap-style headache mentioned above, which Goadsby likens to “a baseball bat to the back of the head.”

Trust your gut

For doctors, perhaps the most important factor when we’re investigating a headache is nothing to do with the headache itself but instead the person experiencing it.

What seems like an innocent headache in a healthy person could be something critical for people with chronic illnesses such as HIV, cancer or even a history of cancer — if this is your situation, you should have a lower threshold to reach out to a doctor with any type of headache that’s new. Likewise, it’s OK to be more guarded about headaches if you’re pregnant, over age 50, have disabilities or have suffered recent trauma such as a fall or concussion.

As with most things in the human body, it doesn’t help to be too rigid when you’re thinking about what’s “serious enough” to worry about. When a headache gives you the feeling that something’s not right, trust your gut — either get immediate, urgent care or write down all the details in a headache log, take it to your doctor and start asking questions.

Kristen Kendrick is a board-certified family physician in Washington, D.C., and a health and media fellow at NPR and Georgetown University School of Medicine.

Menopause: Facts, Phases, Symptoms and Treatment Options

Am I in menopause?

This is a common question that many women ask. Menopause occurs when a woman’s ovaries no longer produce normal amounts of estrogen or release eggs regularly. There isn’t a lab test or specific age when this occurs.

For most women, the process begins around age 45 and lasts about six years with their last period occurring around age 51. Some women have irregular menstrual cycles earlier and stop having periods between ages 40 and 45, which we call early menopause. Some stop before age 40, which is called premature menopause. Women who’ve had surgery to remove their uterus or ovaries, or are undergoing certain treatments for cancer, may experience the symptoms of menopause regardless of their age.

The phases of menopause

The age at which the menopause process starts, how long a woman is in perimenopause, and the symptoms that accompany the irregular cycles is variable and unpredictable. Menopause is generally considered to begin on the date of your last period, whereas perimenopause refers to the years prior to that and are often marked by irregular periods. Postmenopause are the years after your last period.

The symptoms of menopause

There is no one single symptom that’s commonly seen in all women as everyone has a different menopause experience. Some women have very few symptoms, while others have issues that affect their daily lives. Symptoms are usually the most troublesome during perimenopause and can include:

  • Mild warm flashes or hot flashes with profuse sweating.
  • Poor sleep quality.
  • Anxiety, mild mood swings, flares of depression
  • Brain fogginess.
  • Body changes, including weight gain (about 14 pounds) and
  • Fat redistribution to the abdominal area, also known as the “menopouch”, and vaginal dryness and pain with sex
  • Certain changes should be monitored, including rapid loss of bone and the development of atherosclerotic plaques in vessels and coronary arteries.

What about the dreaded hot flashes?

Hot flashes are a common symptom of menopause caused by the hormonal changes in your body. It’s a feeling of intense warmth that can appear suddenly or slowly and cannot be attributed to an external source.

A hot flash may have no clear trigger, but can also be caused by alcohol, hot drinks, caffeine, spicy foods, smoking, or room temperature. They can be as mild as feeling flushed or severe enough to wake you from a sound sleep, also known as “night sweats.” Most hot flashes last 30 seconds to five minutes. They usually disappear within a few years after menopause, but some women may experience them for decades.

Women in menopause can experience hot flashes as often as several times a day. But this experience can vary from one woman to the next and may include:

  • Sudden warm feelings or sweating.
  • Redness of the face, neck, ears, chest, or other areas.
  • Tingling fingers.
  • Racing heart beat or palpitations.
  • Feeling cold or getting the chills as the hot flash ends.

Treatment options for menopause symptoms

The Menopause Consultation Program at the Women’s Medical Collaborative was developed to help women understand what they’re experiencing, anticipate what they may feel, and try to manage their symptoms while maintaining a healthy lifestyle. Our experts can help you choose the best of several options for relieving your hot flash symptoms: 

  • Hormones. These provide many women with relief and offer added benefits for bone health. But hormones are not for everyone. Some women prefer not to, while others can’t due to certain medical conditions such as breast cancer or a history of blood clots.
  • Antidepressants. Newer studies show that some commonly used antidepressants can provide effective relief.
  • Non-medical treatments. We find that women who exercise and maintain a healthy weight have fewer problems with hot flashes. Relaxation exercises and meditation can also help.
  • Cognitive Behavioral Therapy (CBT). This form of psychotherapy may be beneficial for some women.

Other changes during menopause

The loss of estrogen during menopause can cause changes in the vaginal and vulvar skin. These changes can result in vaginal dryness, burning and discomfort, or painful intercourse. Most women need a lubricant. 

There are many different formulations, but silicone-based lubricants are best. Be aware that most over-the-counter lubricants contain preservatives, which can cause irritation. A preservative-free silicone lubricant or natural product, such as extra virgin olive oil or organic unrefined coconut oil, can also work. 

Many women also experience painful spasms of the interior pelvic muscles, called vaginismus. Specialized physical therapy is a very effective treatment. Our center has a group of female physical therapists who are specially trained in pelvic floor rehabilitation. 

Managing menopause symtpoms

Lifestyle changes involving diet and activity level can help manage menopause symptoms and ensure better health afterwards.

  • Nutrition: Reduce or limit caffeine and alcohol, eat estrogen-containing soy foods, and ensure you receive adequate calcium and vitamin D.
  • Exercise: Daily exercise helps with heart health, muscle and bone health, and stress reduction. Resistance exercises can also help your balance.
  • Mindfulness-based techniques: Yoga and meditation help greatly with mood and sense of well-being and can also relieve hot flashes.
  • Manage your health: Maintain good health and minimize age-related conditions by controlling your blood pressure, cholesterol levels and weight, and quitting smoking.

Discuss any changes or health concerns with your provider. All women should be an informed and active participant in their health care choices.

Internal Fever: What Is It, Symptoms & What To Do

In cases of ‘internal fever’ you can feel very hot but the thermometer does not show this rise in temperature. The most common situation is that a person has the same symptoms as a real fever, such as malaise, chills and a cold sweat, but the thermometer is still at 36 to 37 °C, which does not indicate fever.

Although you may complain that your body feels very hot, in fact, the ‘internal fever’ does not exist, it is just a popular way of expressing that you have  the same symptoms as a normal fever, but the degree of the fever is not felt on the palm of your hand, nor is it verified by a thermometer.

Main symptoms of a common fever

In a common fever, in addition to your temperature rising above 37.5 ºC, there are symptoms such as:

  • Feeling hot;
  • Cold sweats;
  • Chills or shivers throughout the day;
  • Malaise;
  • Headache;
  • Tiredness;
  • Lack of energy.

However, in cases of ‘internal fever’, although all these symptoms are present, there is no rise in temperature that can be measured.

What a fever can indicate

Fever is a response of the body in order to fight harmful microorganisms by raising its temperature, being a natural reaction in cases of infections caused by viruses, fungi, bacteria or parasites. So, a fever is not a disease, it is just a symptom that is associated with many types of diseases and infections.

Fever is only really harmful when it gets above 40 °C, which can happen quickly, especially in babies and children, and can cause seizures.

A mild fever is considered to be up to 38 °C, considered as just a rise in temperature, or simply a feverish state, and not very serious, indicating only that you may need to be alert and take off excess clothing to try to cool your body down to normal temperature, which is about 36º C. Fever above 38.5º C may indicate the need to take fever-lowering medication, as well as other natural methods to normalize body temperature.

The ‘thermostat’ that controls body temperature is the hypothalamus, which is very sensitive to any temperature change. It can cause the body to produce more heat, which is dissipated through the skin, so whenever there is a real rise in temperature, the thermometer is able to indicate this fact. So, it can be concluded that ‘internal fever’ does not exist.

What to do in case of ‘internal fever’

When you think you have an ‘internal fever’ you should take a warm bath and lie down and rest. Often the cause of this fever sensation is stress and anxiety attacks, which can also cause tremors throughout the body.

The taking of fever-lowering medication, such as acetaminophen or ibuprofen, is only recommended under medical advice and when the thermometer registers at least 38.5 °C. If, as in the case of ‘internal fever’, the thermometer does not show this temperature, no medication should be taken to try to fight a fever that does not exist. So, if necessary, you should just take off your excess clothes and take a bath in warm water to try to lower body temperature and alleviate discomfort.

If symptoms persist, you should see your doctor for a physical exam to find out what may be happening. In addition to blood and urine tests, your doctor may also order a chest X-ray, for example, to check for any lung changes that may be causing this sensation of fever.

Possible causes of ‘internal fever’

Emotional causes, such as a stress or anxiety crisis, and women’s ovulation during the fertile phase are the main causes of internal fever. However, you may also find that you have a fever after exercising or some kind of physical exertion, such as carrying heavy bags or climbing a flight of stairs. In this case, the temperature usually returns to normal after a few minutes’ rest.

At the onset of a cold or the flu, feeling unwell, tiredness and heaviness in the body are common, and sometimes people refer to a feeling of ‘internal fever’. In this case, taking a home remedy such as warm ginger tea may be a good way to feel better.

Can ‘internal fever’ be a sign of COVID-19?

‘Internal fever’ can happen when the body tries to fight an infection, appearing as a first sign before a real fever. Therefore, it is possible that some people infected with COVID-19 may experience an internal fever before any other symptoms.

It is then recommended to observe other symptoms that may appear and that are more indicative of infection by the new coronavirus, such as dry cough, excessive tiredness, loss of taste and smell, or fever.

When to go to the doctor

It is recommended you seek medical help when, in addition to the sensation of internal fever, you have other symptoms such as:

  • Sneezing, coughing;
  • Vomiting, diarrhea;
  • Mouth sores;
  • Rapid temperature rises to above 39º C;
  • Fainting or decreased attention span;
  • Bleeding through the nose, anus or vagina, with no apparent explanation.

In this case, it is still important to tell the doctor all the symptoms you have, when they appeared, if you changed something in your diet or if you were in another country, for example. If there is pain, it is still advisable to explain which part of the body is affected, when it started and if the intensity has been constant.

With this information the doctor may suspect a disease and request tests if necessary, indicating the most appropriate treatment.

Health Symptoms: Flushed Face After Eating

Facial flushing is an alarming symptom that may worry you, but with an evaluation from your health-care professional, a diagnosis can alleviate your concern. Most cases of facial flushing from eating are related to food intolerances or a food allergy. It is important to identify the cause of the symptom in order to properly treat it. If you develop other symptoms along with facial flushing, write them down and discuss them with your doctor.

Monosodium Glutamate Intolerance

Monosodium glutamate, or MSG, is a common additive that enhances the flavor of food 4. It is a common ingredient in Chinese food and it can trigger what is called Chinese Restaurant Syndrome. MayoClinic.com reports that MSG has caused the following reactions in some people: flushing, headaches, sweating, chest pain, nausea, vomiting, weakness, numbness and facial pressure.cause:

  • MayoClinic.com reports that MSG has caused the following reactions in some people: flushing
  • headaches
  • sweating
  • chest pain
  • nausea
  • vomiting
  • weakness
  • numbness
  • facial pressure

As of 2011, there have not been clinical studies that provide evidence of a link between these symptoms and the consumption of this chemical. These reactions may occur within 15 minutes or up to a few hours after consuming MSG, according to the American College of Gastroenterology 1.

  • Monosodium glutamate, or MSG, is a common additive that enhances the flavor of food 4.
  • These reactions may occur within 15 minutes or up to a few hours after consuming MSG, according to the American College of Gastroenterology 1.

Alcohol Intolerance

Redness on the Face After Eating

If you notice that shortly after consuming alcoholic beverages your face becomes flush, you are likely alcohol intolerant. Alcohol intolerance is a genetic condition that is passed down your family line and is the result of not being able to digest alcohol 2. MayoClinic.com states that the most common symptoms associated with this condition are skin flushing and nasal congestion. If you receive a diagnosis for alcohol intolerance you will need to avoid alcoholic beverages 2. You may also develop headache, abdominal pain and skin rashes from this condition.

Food Allergy

Eating foods that trigger an allergic reaction can cause facial flushing almost immediately after you finish eating. Food allergies cause a systematic reaction in the body that releases various chemicals to defend the body, which can cause a decrease in blood pressure, leading to flushing of the skin. Common foods that cause:

  • an allergic reaction include wheat
  • eggs
  • milk
  • fish
  • soy
  • tree nuts
  • strawberries
  • tomatoes
  • pineapple
  • peanuts

A severe reaction to a food can cause life-threatening symptoms.


Why Does My Face Go Red After Eating & When Its Hot?

Facial flushing may be a sign of a serious medical condition. If you feel like your throat is swelling or you cannot breathe, call 911. Other concerning symptoms that need to be reported to a medical professional immediately include hives, facial swelling, a rapid heart rate and mental confusion.

When you should worry about your headache | UCI Health

Headaches are one of the world’s most common conditions. Some, such as hunger or stress headaches, go away on their own and aren’t a cause for concern.

Others, such as migraines, have the potential be be more serious.

Migraines can be debilitating, but for some people who experience auras with their headaches, they could be a marker for a more serious danger – an increased risk for stroke.

UCI Health pain management specialist Dr. Rakhi Dayal says women who experience an aura with their migraines have been shown to be at particular risk. Migraines are three to four times more common in men than women.

How migraines vary

Migraines are often described as throbbing or pulsating, but they also can be dull or pressure or sharp. They often occur on half of the head or in a specific location but may involve the whole head, and they sometimes switch from one side to the other.

An aura can be a visual or sensory impairment that can precede or accompany a migraine. Visual auras are more common and are often described as shimmering lights, or as arcs, shapes, colors or patterns. Sometimes visual symptoms can involve dark spots or total or partial loss of vision, Dayal says.

Sensory auras can be felt as tingling or numbness that starts small and spreads to a larger area of the face or limb. Other auras may involve difficulty understanding or expressing language, limb weakness on one side or balance difficulties.

Migraines and stroke risk

People who experience auras with their migraines have double the risk of stroke, according to a 2016 study published in the British Medical Journal.

Being a female smoker under the age of 45 and on birth control increases the risk of stroke even more. Studies have established a significantly higher risk of stroke among women who have migraines with aura. What you should know about preventing stroke ›

Additionally, Dayal says, some studies have shown a possible link between migraines with aura and heart disease. 

It is still unclear whether treating and preventing the migraines could result in stroke risk reduction, said Dayal, but affected women should stop smoking and be cautious about using estrogen in the form of birth control or hormone therapy because of estrogen’s effect on blood clotting and coagulation. Because pregnancy increases the production of estrogen, women who have migraines with aura need to be educated about their elevated risk.

Furthermore, some auras associated with migraines may mimic the symptoms of stroke. Stroke is caused by a blockage in the blood vessels of the brain or by bleeding into the brain. In fact, without proper history and clinical evaluation and tests, it can be difficult to differentiate between stroke and migraine in some patients, Dayal said.

When to see a doctor

People who experience recurring headaches of any type should see a neurologist for a thorough evaluation and examination because an accurate diagnosis is critical to effective treatment, Dayal said.

Episodic tension headaches and sometimes milder forms of migraines may go away with rest, relaxation, and over-the-counter medications, or analgesics. Intense migraine headaches may need special migraine treatments. Frequent headaches — whether tension, migraine or other kind of primary headache — may require preventive treatments with daily medication.

Headache red flags

Some headaches are considered “red flags” because they could be caused by an underlying, life-endangering condition. If you experience any of these symptoms, Dayal says, consult a doctor:

  • Sudden, intense headache that peaks to an unbearable intensity over seconds to minutes, often described as “the worst headache of my life.” This is sometimes referred to as thunderclap headache. This may be caused by life-threatening bleeding in the spaces of the brain, and you should go to the emergency room immediately. Call 911.
  • A new headache that is different from any other previous headache, or an increase in frequency or intensity, or poor response to previously effective therapies.
  • Headache that wakes you up at night.
  • Increased headache when lying down coughing, sneezing or weight bearing.
  • New headache after age 40 if you’ve never had headaches before.
  • Headache accompanied by any symptoms such as: weakness in the face, arm or leg; numbness or coordination problems; visual impairment; language or speech problems; vertigo; confusion; altered wakefulness; or seizures. If those symptoms occur, call 911.

“Take your headache seriously,” Dayal says. “If you are having headaches, see a headache specialist. We can diagnose your headache and treat it.”

Our treatment includes preventive options, as well as Botox injections and other therapies.

Related stories

  • 90,000 Why headaches: the three most common causes

    Medicines that relieve vasospasm help reduce pain.

    Every person has at least once experienced a terrible sensation when the head just “splits”. This usually happens when we are sick or overworked. In the first case, the headache indicates the development of toxinemia – the ingress of dangerous bodies, for example, viruses, into the blood. In the second case, it is about banal processing, violation of the sleep and rest schedule.

    Of course, sometimes the head hurts from a hangover – due to vasodilation after alcohol. However, this condition, for all its troubles, is not considered dangerous. Chronic headaches are quite another matter. By the way, they can be a consequence of a previous throat infection and a regular companion of chronic stress and fatigue.

    Romantics’ disease?

    The most popular headache is migraine. For some time it was believed that exclusively romantic and creative natures were subject to her.However, in fact, anyone can suffer from migraines.

    Characteristic features of migraine: one-sided pain, often dull or spasmodic. Sometimes a person cannot look at white or bright objects and generally does not tolerate light. Some patients complain of nausea and lack of coordination, the appearance of “flies” before the eyes, “goose bumps” on the skin …

    More recently, migraine was considered a disease “from the nerves”, because it really worsens after stress and anxiety.But just a month ago, Western University of Cleveland (USA) proved that migraines have a different origin. In a healthy person, order reigns within the trigeminal nerve: all endings are symmetrically located and create a harmonious “pattern” with other cells. In a patient with migraine, the nerve endings look like “bushes” – now “bundles”, now “bald spots”, and the “pattern” – spots. The myelin protective sheath around such endings is broken. Accordingly, at the slightest spasm, “disordered” nerves experience increased stress.Hence the headache. Scientists cannot yet understand where the asymmetry in the trigeminal nerve came from, but they are convinced that this can be dealt with.

    In addition to stress, migraine attacks are caused by an unpleasant odor, loud sounds, crowds of people – depending on what annoys and strains a person most of all.

    As a rule, medications that relieve vasospasm help relieve pain. Now American doctors are trying to patent a new type of treatment – with the help of neurotoxins, which neutralize the sensitivity of nerve endings for 6-12 months.

    “Helmet” from fatigue

    If the feeling is that something is squeezing the head around the circumference, pressing on the forehead and eyes, then it makes sense to talk about tension pain. Their nature is poorly understood, but it is known that people with nervous disorders most often complain.

    – Feelings are very unpleasant. It was as if a “helmet” was put on a person’s head, which is too tight for him, – says cardiologist Eduard Gritsenko. – Such symptoms are, for example, with classical neurasthenia.They can be caused by prolonged stress, heavy workload, insomnia.

    Tension pains are short-lived and can be tied to the time of day. For example, people who get up early and work hard during the day often have headaches in the evening.

    Typically, an attack lasts 5 to 60 minutes. The pain can be either dull or unbearably pressing. Patients with tension pain often report that they have a “bursting skull.”

    There is no specific treatment for this ailment.Except perhaps to stimulate blood circulation in the brain. For this, it is better to exercise regularly. A half hour of vigorous walking, fifteen-minute jogging or morning warm-up is enough. Have a long day at work? Plan a little walk in the afternoon.

    If the attack has already begun, the usual pain reliever relieves the unpleasant sensation.

    Curse for Men

    Throbbing one-sided pain in the area of ​​the eye, which at the same time begins to water.Often accompanied by a runny nose. The person’s face turns red due to the rush of blood. These are the so-called cluster headaches. Their origins also remain very vague for scientists. It is only known that it is mainly men who suffer from such a debilitating sensation. And a few – only about 1%.

    The attack usually lasts about an hour, without reference to the time and season. Discomfort is relieved with pain relievers. But it is known that even after a course of treatment, attacks often recur.


    Urgently see a doctor!

    • Unbearable headache, which is accompanied by nausea and vomiting, occurs with meningitis – inflammation of the soft tissues of the brain. This disease can be fatal, therefore it is very dangerous to postpone hospitalization. Other symptoms of meningitis: high fever, cramps, stiff neck muscles (it is impossible to reach the neck with the chin).

    • Headache, in which weight is abruptly lost, there are cramps and nausea in the morning – characteristic of brain tumors.The neoplasm causes an increase in intracranial pressure due to its size. But pain occurs only in 5% of cases of brain cancer.

    • Severe pain radiating to the shoulder and neck is characteristic of temporal arteritis – vascular inflammation. It often develops as a complication after serious viruses. The danger of the disease is that sometimes it can lead to blindness if treatment is not started on time.

    • Sudden pain with impaired coordination or speech is characteristic of cases of rupture of blood vessels in the brain during trauma.It is often possible to live a full life after a hemorrhage, but its consequences can be very serious. Therefore, do not hesitate to call an ambulance!

    READ ALSO: How not to treat a cold

    90,000 Rabies – symptoms and treatment

    Rabies is a disease of a viral
    nature, arising after the bite of an infected animal, characterized by
    severe damage to the nervous system and usually ending in
    fatal.Rabies virus (Neuroryctes rabid) belongs to the group
    mixoviruses of the genus Lyssavirus of the family Rhabdoviridae. Found in saliva
    and also in tears and urine.

    unstable in the external environment – dies when heated to 56.C in 15 minutes, when
    boiling for 2 minutes. Sensitive to ultraviolet and direct sunlight
    rays, ethanol and many disinfectants. However, it is resistant to low
    temperatures, phenol, antibiotics.

    penetration into the body, the rabies virus spreads through the nervous
    endings, affecting almost the entire nervous system.There is swelling
    hemorrhages, degenerative and necrotic changes in nerve cells
    brain and spinal cord.

    rabies virus are both wild and domestic animals. To the wild
    include wolves, foxes, jackals, raccoons, badgers, skunks, bats,
    rodents, and pets – dogs, cats, horses, pigs, small and large
    cattle. However, the greatest danger to humans is represented by foxes and
    stray dogs outside the city in the spring and summer.Animals are considered contagious
    3-10 days before signs of illness appear and then throughout the entire period
    diseases. Often animals with rabies can be distinguished by abundant
    salivation and lacrimation, as well as when observing signs of hydrophobia.

    a person occurs when bitten by a “rabid” animal. And also at
    contact with the saliva of a sick animal on damaged skin or mucous membranes
    shell. In recent years, airborne, alimentary (through
    food and water) and transplacental (through the placenta during pregnancy) pathways
    transmission of the virus.Several cases of human infection are controversial.
    rabies as a result of organ transplant operations.

    the period (the period from the bite to the onset of the disease) averages 30-50
    days, although it can last 10-90 days, in rare cases – more than 1 year. Moreover
    the farther the bite is from the head, the longer the incubation period. A particular
    the danger is bites to the head and hands, as well as child bites.
    The incubation period lasts the longest with a bite in the legs.

    Allocate 3
    stages of the disease: I – initial, II – excitement, III – paralytic. The first
    stage begins with general malaise, headache, slight increase
    body temperature, muscle pain, dry mouth, loss of appetite, pain in
    throat, dry cough, there may be nausea and vomiting. At the site of the bite appear
    discomfort – burning, redness, pulling pains, itching, increased
    sensitivity. The patient is depressed, withdrawn, refuses to eat, he has
    there is unexplained fear, melancholy, anxiety, depression, less often – increased
    irritability.Insomnia, nightmares, olfactory and visual hallucinations are also characteristic.

    Through 1-3
    day, the patient with rabies begins the second stage – excitement. Appears
    restlessness, anxiety, and, most characteristic of this stage, seizures
    hydrophobia. When trying to drink, and soon even at the sight and sound of pouring water,
    there is a feeling of horror and spasms of the muscles of the pharynx and larynx. Breathing becomes
    noisy, accompanied by pain and convulsions. At this stage of the disease, a person
    becomes irritable, excitable, very aggressive,
    “mad”.During seizures, patients scream and rush about, they can
    breaking furniture, showing superhuman strength, throwing themselves at people. It is noted
    increased sweating and salivation, it is difficult for the patient to swallow saliva and
    spits it out all the time. This period usually lasts 2-3 days.

    the third stage of the disease begins, for the onset of which sedation is characteristic
    – fear disappears, attacks of hydrophobia, there is hope for recovery.
    After that, the body temperature rises above 40 – 42 degrees, paralysis of the limbs and cranial nerves of various
    localization, impaired consciousness, convulsions.Death comes from paralysis
    breathing or cardiac arrest. Thus, the duration of the disease
    rarely exceeds a week.

    Rabies treatment

    there is no cure for rabies as such. If the disease is already in the first stage, otherwise
    an outcome than fatal, most likely, will not be. Although the world knows only a few
    cases of cure for rabies. But for now it is exotic.

    there is a way to prevent disease by killing it in the bud.This is the method
    specific prophylaxis – the introduction of a special vaccine against rabies,
    no later than the 14th day from the moment of the bite. The best specific prophylaxis is
    this is the introduction of a specific immunoglobulin and / or active immunization

    The vaccine is administered
    intramuscularly 1 ml 5 times: on the day of infection, then on the 3rd, 7th, 14th and 28th
    day. With this scheme, good immunity is created, but WHO also recommends
    and the 6th injection 90 days after the first.

    The best
    the site of inoculation is the deltoid muscle of the shoulder or thigh. In that case,
    if a person is bitten, but was vaccinated according to the full scheme before the bite, and he has
    a sufficient level of antibodies, it is vaccinated according to a special scheme without
    the use of immunoglobulin.

    can be discontinued if it is found that the animal remains healthy in
    during the 10-day observation period or if the animal did not have
    rabies virus detected.

    persons who are at risk (veterinarians, dog handlers, hunters) need
    be vaccinated in advance. Vaccinations are also carried out specifically
    the established scheme with the first revaccination after 12 months. and then every
    5 years.

    do if you get bitten?

    what needs to be done is to immediately wash the bite with soap. It is necessary to wash
    quite intensely, for 10 minutes.Deep wounds are recommended
    flush with soapy water, for example with a syringe or catheter. Not
    you need to cauterize wounds or apply stitches.

    this you need to immediately contact the nearest emergency room, because success
    rabies vaccination is highly dependent on how quickly you
    turned to a doctor for help. It is advisable to inform the doctor at the emergency room
    the following information – a description of the animal, its appearance and behavior,
    the presence of a collar, circumstances of the bite.

    a course of vaccinations prescribed by a doctor should be carried out. Forty injections in the stomach
    no one has done it for a long time, you will be given a vaccine and sent home. And so five or
    six times. A bitten person can be left in the hospital if his condition
    especially severe, re-vaccinated, as well as persons with diseases
    nervous system or allergic diseases, pregnant women, as well as persons
    other vaccinations in the past two months.For a while
    vaccination and 6 months after it, you must refrain from
    drinking alcoholic beverages. In addition, if you are undergoing a vaccination course
    from rabies, you cannot overwork, overcool or vice versa

    vaccinations must be closely monitored for health. And for any
    complaints of deterioration, it is necessary to consult a doctor, and vaccinations
    temporarily stop. Only after examination by a neurologist, therapist and
    the rabiologist consultatively decides on the continuation of vaccinations.

    Neurologist Alexey Sergeev – about a breakthrough in the treatment of migraine

    Breakthrough in treatment

    The molecule that triggers a migraine attack, CGRP (calcitonin gene related peptide), was discovered back in 1984. For more than 30 years, scientists have tried to find a way to influence it in order to come up with an effective drug for the treatment of migraines. And only last year, the FDA (Food and Drug Administration) – the organization that registers and controls drugs in the United States – registered the first drug for use, and then the second and third, which reduce the number of migraine attacks by blocking the activity of this molecule or its receptor.So far, the drugs are allowed only for adults, but clinical trials are already underway for children. Two of these drugs are already registered in Europe. In Russia, they have been at the registration stage since last year, and we hope that the drug will appear in our country in the fall. Therapy consists of a subcutaneous injection once a month (for one of the drugs, once every three months). In 20% of patients, seizures disappear almost completely, in the rest, the frequency of seizures significantly decreases. Now another type of drugs is being developed that act on the same molecule, which perfectly relieves pain already at the time of an attack.Even triptans, drugs for moderate to severe migraine attacks, are only 70% effective, and newer drugs are expected to be more effective and better tolerated. They are now in the third phase of clinical trials. Together, these developments are a real breakthrough in the prevention and treatment of migraines.

    Types of headaches

    A headache can have more than 150 different causes. A headache, like any pain, can be a sign of danger if some structure is damaged in the body – a vessel, shell, skin, joint or ligament.This pain is called symptomatic or secondary headache. In this case, doctors need to understand where the danger signals the pain are and treat the cause.

    But much more often a headache is a manifestation of an independent neurological disease. Such pains are called primary, and they account for approximately 95% of all headaches. Among them, it makes sense to distinguish three main groups – tension headache, migraine and rare, but very severe options – trigeminal autonomic cephalalgia.

    It happens that before a headache appears during a migraine attack, a person’s vision changes – there are certain flashes before the eyes, flickering zigzags, spots, transient numbness of the face or hand. This is called a migraine aura. According to recent reports, migraine with aura is a slightly different disease than migraine without aura. Migraine attacks with aura are less frequent but more severe. In certain embodiments, migraines with aura are treated differently.

    A person does not die from primary headaches, and usually they do not lead to any complications, but they can seriously ruin life.

    Photo: Maria Mozharova

    Myths about migraines and unnecessary tests

    There is a common myth that one of the most common causes of headache in children and adults is associated with problems in the cervical spine. In reality, such a relationship is extremely rare, and in such situations we are talking about a cervicogenic headache. In Russia, this term has been replaced by “cervicocranialgia” – from the words “cervical” (cervical) and “cranial” (cranial) – cranial. In Russia, there is a huge overdiagnosis of this syndrome, this is a very common diagnosis in our country, although in reality this situation is less than 1% of all headaches.Indeed, 80% of migraine attacks begin from discomfort in the neck, but this is due to the fact that the trigeminal nerve system is connected by the occipital nerve. As a rule, with headache attacks, neck pain is a consequence of the onset of a migraine attack, and not its cause.

    For the diagnosis of primary forms of headaches (migraine, tension headache), as a rule, it is absolutely useless to conduct ultrasound of the vessels of the neck and head and laboratory tests. In the presence of warning signs of symptomatic headaches, an MRI of the brain is sometimes possible, but after consulting a doctor.In very rare cases, for atypical migraine attacks with aura, electroencephalography (EEG) may be done. But in most cases, performing an EEG for headaches is a waste of time and money. In general, if a doctor for headaches prescribes an X-ray of the cervical spine, electroencephalography, rheoencephalography (REG), vascular ultrasound and explains the headaches “by a violation of cerebral blood flow or by clamping an artery in the neck”, this means that you need to see another doctor.

    In 2016, a large study was carried out, for which the genetic data of more than 300 thousand patients were analyzed to study the genetics of migraine.Scientists have identified 44 nucleotide polymorphisms associated with an increased risk of migraine headaches. But this is not a diagnostic test system. Simply put, no biochemical or genetic tests currently exist and cannot be done to confirm the diagnosis of migraine. There are only clinical criteria for the diagnosis, collected on the basis of a conversation with a patient and his examination. They are clear and simple enough. In most cases, with their help, it is not difficult to diagnose migraine.All additional examinations are done only if other possible causes of the headache are suspected.

    Nootropics and useless medicines

    Until new drugs for migraine are registered in Russia, we use drugs from the group of antidepressants, anticonvulsants and other pharmacological groups (b-blockers, Ca-channel blockers), the effectiveness of which has been proven. Drugs that supposedly improve blood circulation in the brain are ineffective for migraines and headaches.The mechanism of development of headaches and migraines, in particular, has nothing to do with circulatory disorders, this is known and proven more than 30 years ago. There is not a single drug that “improves blood circulation.” These drugs have shown efficacy in animal experiments, but none have shown efficacy in human clinical studies. Apparently, all these “vascular”, “nootropic” drugs were invented not for patients, but for doctors. Treatment of chronic neurological diseases has a rather low effectiveness, and therefore, instead of explaining to patients that there is no effective therapy, it is easier to give some medicine – albeit useless, but safe.This is the use of the placebo effect, not in research, but in practice – nice words in response to the patient’s expectations, temporary improvement and no effect after one to two months.

    In recent years, another widespread myth has emerged, born of popular TV broadcasts, that there is a “magic” injection in the back of the head – occipital nerve block, which supposedly instantly helps all patients with migraine. People come to us and say: give me an injection as soon as possible! Unfortunately, in reality, not everything is so optimistic.In fact, this is a really good method, which has its place in the treatment of chronic migraine, but in addition to drug therapy, with the ineffectiveness of this therapy. The effectiveness of the injection was evaluated in patients with chronic migraine – those who have 15 attacks per month or more. The blockade of the occipital nerve leads to a decrease in seizures by several days a month – there were 15 seizures, after the injection it decreased slightly, for a short time, but recovery did not occur.So this is not a panacea.

    Tension headache and migraine

    More than 90% of people periodically experience tension headache in their lives. If we work for a long time in a static position at the computer, sit in gadgets, in a stuffy room, we may experience bilateral, squeezing pain in the temples or in the crown of the head. Usually it is easy – on a ten-point scale by about 3-4 points. For the pain to go away, you just need to leave work, take a walk, drink coffee, get some air, go to workout.Only if the pain lasts a long time, does not go away, it becomes stronger, it makes sense to take a pill.

    Migraine is a different story, it is a disease that manifests itself as a headache plus more symptoms. As a rule, an attack, in addition to pain, is accompanied by nausea, increased sensitivity to light, sounds and smells. Migraine can be bilateral or unilateral, migraine attacks are severe or mild, but even with a mild attack, pain is difficult and unnecessary to endure. Without the timely use of anesthetic, the attack usually intensifies to severe and may be accompanied by vomiting.If you do not take medication, the attack lasts from four hours to three days. During a mild attack, simple drugs can be effective – ibuprofen, paracetamol and other pain relievers, which are sold in any supermarket around the world. If migraine attacks are rare – once a month or two, a person knows a drug that helps him get rid of pain, then there is no particular need to see a doctor. There is enough information about migraine triggers that patients themselves can figure out which triggers are relevant for them – dark chocolate, red wine, hard cheese, or lack of sleep.If attacks occur more than twice a month, or if their frequency and severity begin to increase or are accompanied by other symptoms, this is a reason to see a doctor.

    As for the choice of drugs, there is neither a perfectly safe drug, nor any particularly strong and terrible drug. Any pain reliever is unsafe with frequent and prolonged use. For migraines, it is important to use the drugs in the correct dosage. For example, they often take 200 mg ibuprofen and then say that they are not working.In fact, this is a children’s dosage, an adult needs at least 400 mg. The second important point is that for the drug to help, it must be taken on time and washed down with a sufficient amount of water (200-300 ml). If you draw a curve from mild to severe headache on the graph, you need to take the medicine within half an hour from the moment the pain begins to build up.

    It is important to remember about the risk of developing an abusal headache, or, in other words, a drug-induced headache. Each drug has its own permissible conditional “norms” – for example, ibuprofen has no more than 15 tablets per month.Exceeding these “norms” for a long time leads to the fact that headaches occur more often. Our favorite combination analgin-containing analgesics can quickly cause abusal headache and are considered a reserve, and not the first choice for pain relief for headaches. There are restrictions on the use of painkillers in different groups of patients, for example, ibuprofen is prohibited for pregnant women from the third trimester. Often migraines can “fall asleep”, regress during pregnancy.But if seizures persist during pregnancy, then this is a reason to consult a doctor and clarify what can be taken and what not.

    For moderate or severe migraine attacks, it is useless to take simple pain relievers; in such cases, other medications are needed. This is a fairly large group of drugs, which is collectively called triptans. If the attack begins with nausea, which is then connected to a headache, no matter what drugs you take – triptans or simple pain relievers, their effectiveness can be sharply reduced.This is due to migraine gastrostasis – a violation of the absorption of the drug in the gastrointestinal tract. In the case when the attack begins with nausea, we can advise the patient to take a pill for nausea plus a drug for migraine – together the effectiveness will be much higher. In the world there are special sprays with triptans, instant form, and there is a special subcutaneous injector with triptan, effective in more than 90% of cases – they allow you to enter the drug into the body, bypassing the gastrointestinal tract, which significantly increases their effectiveness.But, unfortunately, they are not registered in Russia – we only have ordinary triptan tablets.

    Trigeminal autonomic cephalalgia (TVC)

    Trigeminal autonomic cephalalgias are a group of rare primary headaches characterized by very severe pain, 10 points out of 10 possible. They are always one-sided, in the temporal zone or eye area. This term comes from the words “cephalgia” – headache, “trigeminal” – associated with the trigeminal nerve, and “vegetative”, because for these diseases, typical is a bright vegetative accompaniment strictly on one side – lacrimation, redness of the eye, eyelid edema, covering eyes.The attacks of TVC are short, from a few seconds to an hour and a half. Sometimes these pains are called suicidal, because cases are described when people tried to commit suicide, unable to bear. Fortunately, today doctors have the opportunity to help patients with TVC, remove pain at the time of an attack and reduce their number.

    Photo: Maria Mozharova

    Headaches in children

    Children’s headaches are a separate important topic. Recently, a family from Altai – the parents of a five-year-old boy – came to our clinic of nervous diseases after a sad history of going to different local hospitals with complaints of periodic changes in vision and headaches.After examinations, we excluded all possible symptomatic causes of pain and came to the diagnosis of migraine with aura. Unfortunately, migraines in children can start early, at the age of 5-7 years, but, as a rule, these attacks are rare and do not require any ongoing therapy. We discussed all this with my parents, and they went to their home in Altai relieved. The child continued to play sports, and seizures were very rare. However, this story had a continuation. The parents decided to continue to consult in various regional clinics, and within a year the child’s diagnosis was changed three times – they mentioned stroke, aneurysm, increased intracranial pressure, developmental disorders and other horror stories that have no justification, except for denying the simple fact that migraine may be in children.

    Unfortunately, this is a common situation. Migraine at the age of 10–17 years occurs in children as often as in adults, but still in our realities it is hidden under the dubious diagnosis of VSD, or “instability of the cervical spine,” or increased intracranial pressure. Often at the same time, some absolutely unnecessary, ineffective “vascular” drugs are prescribed. Parents turn to us and say: “We had periodic headaches somewhere in the third grade, and now we are already in the eighth grade, we constantly do examinations – we do not find anything, but we are being observed with a diagnosis of VSD.”The usual reception of a child with a headache is huge folders of the results of dubious examinations, which means that terrible nerves and anxiety of parents, often completely in vain. And the child grows up with the feeling that he is sick with something serious and incurable.

    It has been known for more than 50 years that boys have the onset of migraine at the age of 6–7 years. In girls aged 12-13 years. In adolescence, the ratio changes to the same as in adults – girls suffer from migraines three times more often than boys.If we take all schoolchildren from 6 to 18 years old, 10% will have migraines, 40-50% will have tension headaches.

    Headache provocateurs in children

    Of course, when we meet with a child with complaints of headache at the first visit, it is important for us to exclude possible symptomatic causes. Sometimes a survey and a neurological examination are enough for this. It is not at all necessary to appoint a huge number of examinations. After making sure that the diagnosis is migraine or tension headache, the doctor must determine what provokes the attacks.In children, it is very important to understand what the triggers / provocateurs of headache are. For example, there is such a phenomenon as the migraine on Monday morning. On weekends, the child goes to bed later, and on Monday gets up at his usual 7 in the morning – changing sleep patterns and lack of sleep can provoke a migraine attack. Often, children do not eat at school because the food there is not tasty or they are embarrassed to eat the food they brought with them – hunger, as well as sleep disturbance, is one of the most common migraine provocateurs. In children, in many cases, the factors that lead to an increase in migraines and tension headaches lie in the psychological field.School relationships, family relationships, and anxiety are major problems that can lead to chronic pain. Therefore, the treatment of childhood headaches is often carried out in conjunction with a psychotherapist.

    If the child has 3-4 migraine attacks per month, we will try behavioral therapy first, not drug therapy. If you adjust the regime – sleep, nutrition and reduce psycho-emotional stress, add regular aerobic exercise, only this can sometimes reduce 30-40% of headaches.But if migraine attacks are frequent, for three or more months, their frequency does not decrease against the background of non-drug therapy, then drug therapy is needed. There are medications that can effectively reduce the number of seizures. It is important to note that these are not drugs from the “vascular” or nootropic group – their effectiveness has not been proven in the treatment of headaches, either in adults or in children. For the prophylactic treatment of migraine in children, drugs with proven efficacy are used (b-blockers, Ca-channel blockers, some anticonvulsants, and others) approved for use in pediatric practice.

    For the course (prophylactic) treatment of tension headache in children, there is not a single drug with proven high efficacy. Sometimes amitriptyline can be used, an antidepressant that is prescribed for chronic, daily pain, but this is a “despair therapy.” When treating frequent and chronic types of tension headaches in children, it is correct to focus on cognitive-behavioral psychotherapy, analyzing the situation in the family, at school and on solving problems that cause overstrain in the child.

    Abdominal migraine and other unusual migraines in children

    In children, migraine can manifest itself not only as a headache. There is a separate group of conditions associated with migraine in children. For example, an abdominal migraine does not manifest itself with headaches, but with recurrent abdominal pain. Children with migraine also often have kinetosis – a tendency to motion sickness in transport. Another option for the equivalent of a migraine is attacks of dizziness, which occurs abruptly, lasts from several minutes to several hours and disappears without a trace.Known syndrome of cyclic vomiting in children 4-6 years old, when vomiting develops many times during the day, not associated with either metabolic or gastroenterological disorders. It is important to keep in mind that such children’s periodic syndromes can be considered the equivalent of migraine only after excluding all possible other causes – gastroenterological, neurological, ENT pathology (for episodes of dizziness), etc. All these symptoms, as a rule, require examinations and only after that, they can be diagnosed as a childish variant of migraine.

    On the diagnosis and treatment of headaches in Russia

    Just now I had a second-year student at the Moscow medical university. From the age of 14, she was given meaningless nootropic drugs once every six months, allegedly for headaches. At first she felt better, and then after a couple of months it got worse. The trigger for her migraine was actually anxiety disorder, which had no cure. Now she already has a chronic migraine, she drinks more than 30 painkillers a month, she has anxiety disorder and sleep disturbance – the girl is forced to take an academic leave.

    There are many such undiagnosed and neglected cases, but in general it is worth noting that the situation in Russia is beginning to change in a positive direction. Modern Russian clinical guidelines for the diagnosis and treatment of headaches have been developed by my colleagues, they are absolutely adequate and meet international standards.

    I teach with students and lately I see that most of the younger generation of doctors strives for modern knowledge and does not think of itself in isolation from global practice and medical science.Recently at Sechenov University, my colleagues and I received an educational grant and developed a program for students, residents and doctors “Diagnostics and treatment of headaches.” In parallel, colleagues from the university headache clinic conducted the first educational course on the treatment of headaches under the auspices of the European Headache Federation. Many young doctors are interested in the problem and strive to receive objective information about the diagnosis and treatment of headaches in children and adults.I really hope that this will ultimately turn the Russian situation around.

    Asya Chachko

    90,000 Beware of the sun!

    Tired of a long and snowy winter, we enjoy warm days and a bright sun. But our joy can be marred if excessive sun exposure results in sunburn. Unfortunately, the statistics of visits to medical institutions for sunburns has increased dramatically: only on May 15, 2013 to the emergency hospital in Moscow.Minsk received 5 patients with sunburn.

    Sunburn is an inflammation of the skin caused by overexposure to ultraviolet (UV) radiation. UV rays are invisible light waves emitted from both the sun and tanning lamps. The most intense ultraviolet radiation is observed in the middle of the day from 10 am to 4 pm, especially in late spring, summer and early autumn. It is important to know that you can get sunburn even in cloudy weather.because clouds do not trap ultraviolet rays). In addition, UV radiation tends to reflect off surfaces such as snow, water or sand. There is an increased risk of “reflected” radiation exposure when near such surfaces.

    Sunburn is harmful to both skin and eyes. They cause DNA damage in skin cells, thereby increasing the risk of skin cancer and melanoma. So the highest incidence of melanoma is observed in countries with a high level of solar exposure, such as Australia, USA.Sunburns in childhood and adolescence significantly increase the risk of skin cancer and melanoma. In addition, repeated excessive ultraviolet radiation leads to dryness and premature aging of the skin, the appearance of age spots and even the development of cataracts.

    Sunburn symptoms

    • Skin reddened, hot to the touch
    • Pain, edema
    • Bubbles
    • High temperature
    • Chills
    • Headache, dizziness, nausea, weakness, rapid pulse, breathing (signs of sunstroke)

    The severity of skin damage and the symptoms of sunburn are in direct proportion to the time of exposure and the dose of UV.

    Burns are most dangerous for people with immunodeficiency who drink alcohol, take drugs with photosensitizing properties.

    Individuals with certain skin pigmentation disorders (eg albinos) and those with particularly fair skin have an increased risk of sunburn. In dermatology, six types of skin are distinguished in terms of their sensitivity to ultraviolet radiation.

    Types 1 and 2: High sensitivity

    • The first type is blondes or redheads with very light (pale or milky white) skin (possibly freckled) that never tans.Such people can get burned after being under the midday summer sun for less than half an hour.
    • Skin of the second type is slightly darker, possibly with freckles, capable of acquiring a slight tan, but easily burns with a short exposure to the sun.

    Types 3 and 4: Medium sensitivity

    • The third type of skin (the so-called Central European) is darker than the skin of the second type. Sun exposure can cause mild burns or light brown tanning.
    • Type 4 olive skin has a low risk of burns. Tans well to medium brown.
    • Types 5 and 6: Low sensitivity
    • Skin type 5 is dark. Burns are rare, the tan is dark.
    • People with type 6 skin have black skin and never get burned.

    First aid for sunburn

    1. 1. Immediately hide in the shadows. Reddened skin is a symptom of sunburn.Further exposure to the sun will only worsen the burn.
    2. 2. As with any sunburn, the affected area of ​​the skin must be cooled. To do this, you can use cold water or aqueous solutions of antiseptics (for example, furacillin, chlorhexidine). If bubbles have formed, you cannot open them on your own, you should apply bandages with antiseptics and seek medical help.
    3. 3. Drink plenty of fluids.
    4. 4. In case of a large area of ​​sunburn and deterioration of the general condition, seek medical attention.
    5. 5. In no case should you smear the affected areas with oil, lard, urine, alcohol, cologne and ointments, etc., not intended for the treatment of burns. The use of such products can lead to deterioration of the condition, as well as skin infection.
    6. 6. Regularly moisturize “burnt” skin with special products designed for this.
    7. 7. Wear loose, natural fabrics that cover the sun as much as possible. Rough fabrics or synthetics will irritate the skin.
    8. 8. Avoid open sun, even when using sunscreen.

    Prevention of sunburn

    • Limit sun exposure, especially from 10:00 am to 4:00 pm.
    • Wear protective clothing: wide brimmed hats, trousers, long sleeved shirts. Protect your eyes – wear sunglasses (glass or UV-impervious plastic lenses, which should be reflected on the label).
    • Use sunscreen 20-30 minutes before sun exposure. This will allow the cream to take effect. Renew your sunscreen at least every two hours and every time you swim.

    We wish you good health and pleasant rest!

    VT Leshchenko, Head of the Burns Department, UZ “GKBSMP”

    Children’s head injuries | Kaplan Medical Center

    Head injuries are very common in children, however 60% of them are minor and do not cause any damage.In most cases, the infant or child will cry because of the suddenness of the pain resulting from the shock, but very soon the crying will stop and the child will continue to behave as usual. Thus, most cases do not require special treatment or any checks other than parental supervision at home.

    Is a hematoma (bruise) in the impact area dangerous?

    Bumps usually show no visual signs other than some redness or superficial abrasions.Sometimes a red-blue swelling may occur at the site of the impact, which means a subcutaneous hematoma in the area of ​​the impact. The occurrence of a hematoma is not surprising because the scalp area is abundantly covered with blood vessels. Therefore, if an external injury occurs, the bleeding from it will be relatively greater compared to similar injuries to other parts of the body, and the internal injury will be a subcutaneous hematoma.

    How to treat a hematoma?

    Apply something cold, wrapped in cloth.

    How to stop bleeding?

    If there is external bleeding from the wound, apply pressure to the impact site with a piece of mark or other tissue.

    When can you calm down and understand that we are talking about a slight bruise?

    In the following cases, you can understand that we are talking about a slight bruise and that you can monitor the child at home:

    • This is a fall from a small height (high altitude is more than a meter in infants up to two years old).
    • Trauma is not the result of a road accident
    • No significant penetrating trauma
    • Trauma is not the result of bullying (fundus check should be done in any case of suspicion of intentional trauma and a social worker should be reported)
    • No sign of loss of consciousness or seizures
    • Child behaves normally again after a few minutes
    • Child has not vomited more than twice after injury
    • No prolonged or significant headache developed after injury

    When can the child be allowed to sleep after a head injury?

    The child can sleep after a head injury, sleep will not hurt him.However, if it seems to the parents that the drowsiness is significantly increased, so much so that it is difficult to wake up the child, you should contact the emergency room.

    When should I go to the emergency room for examination?

    It is important to come to the emergency room in the following cases:

    • The injury was serious or the fall was from a considerable height (more than a meter), even if the child looks completely healthy
    • The child suffers from severe prolonged headaches
    • The child suffers from nausea / vomiting for a long time
    • The child shows anxiety or, on the contrary, indifference
    • There is a cut at the site of the injury that requires suturing or gluing
    • The injury happened to a baby under the age of one year

    Please note that a fee is charged for visiting the emergency room.

    How to recognize a concussion?

    In more serious cases, signs of concussion may develop: persistent vomiting, significant dizziness without anatomical abnormalities. A child who has signs of a concussion will usually be hospitalized to monitor the development of the problem. In most cases, the child will be discharged home after 24 hours of follow-up.

    How to make sure that there is no skull fracture?

    In more serious cases, a skull fracture may occur.In most cases, we are talking about a “linear” fracture, that is, a crack. Diagnosis is by CT, in which case hospitalization is required for observation for several days to make sure there are no signs of internal trauma.

    When can a head injury be life-threatening?

    Internal bleeding can be very dangerous and can lead to irreversible damage and even death. The reason for this is the accumulation of blood in the intracranial box and its pressure on the soft tissues of the brain.Internal bleeding is diagnosed with a CT scan of the brain. Bleeding inside the skull can be dealt with through urgent neurosurgery to drain blood and relieve pressure.

    How to avoid such injuries?

    It goes without saying that prevention is the most important thing. Falling off a bike, scooter or roller skates can be very dangerous if the child is not wearing a helmet. Therefore, it is very important to choose the right size for your helmet.

    Adult head circumference – from 51 to 62 cm on average, in children from the age of 8 years, the head circumference reaches about 80 percent of its final size.On the packaging of the helmet, its girth is indicated in centimeters, as well as information about the size – small, medium, large.

    When riding a bicycle, scooter or roller skating, carefully fasten the helmet straps under the chin and turn your head to make sure the helmet does not fall off. A helmet that is too large can be very dangerous and cause more damage in the event of an accident.

    It is very important that the helmet is made of two types of material, or fused together to make it durable.A quality helmet will also be made of shock-absorbing material, such as whipped polyurethane, which is fall-resistant to protect the head. So even if the bottom layer breaks on the first blow when dropped, the top layer of the helmet will hold it and protect it from the next blow. It is very important to purchase a helmet with a rear sizing adjuster, which will allow the helmet to fit more tightly on the skull. Of course, you should make sure that the helmet meets all required standards.

    We wish you health,

    ICU staff

    Typical vaccination reactions

    We work seven days a week

    The grafting material contains microorganisms, their components or produced toxins.The task of vaccination is to expose the body to a small dose of the disease to develop immunity, so that when the virus enters the body, the disease does not arise or it is transferred in a mild form.

    There is a wide variety of vaccines available. Some drugs can cause side effects. Among the local reactions, one can distinguish increased sensitivity at the injection site, slight redness and even small seals. General reactions are a feeling of weakness, fever, nausea, headaches.

    The causes of complications after vaccination are:

    • characteristics of a particular organism;
    • weakened immune system, vaccination during illness or convalescence;
    • violation of the rules for transportation, storage of the vaccine or non-compliance with the technique of drug administration.

    An allergic reaction to one of the vaccine preparations can provoke the development of complications. You need to understand that you should not be vaccinated with an exacerbation of chronic diseases.If the immune system is weakened, it will not be able to protect the body from the action of the injected drug.

    To minimize the risk of complications after vaccination, immediately before visiting the vaccination office, you should consult a pediatrician or general practitioner. The specialist will conduct an examination, assess the patient’s well-being, and only then decide on the possibility of being vaccinated. If contraindications are identified, the doctor will make a medical withdrawal. In this case, the vaccine will be administered later.

    What are the consequences of individual vaccines

    Adverse reactions indicate that the body reacts to the appearance of a foreign antigen. The normal process of the formation of immunity begins. However, it will not be superfluous to know about the reactions to certain types of vaccinations. This will allow you to prepare for the vaccination and not panic after it.

    Redness and slight induration are sometimes observed after diphtheria vaccination. The temperature may rise briefly. When febrile seizures occur, an antipyretic, such as paracetamol, can be given.

    HIB vaccination may be accompanied by fever and slight induration. Most often, there is no reaction.

    Vaccination against hepatitis is accompanied by headache, fatigue, and malaise. There will be a slight lump at the injection site for a couple of days.

    Every sixth child responds to the measles vaccine. Within a few days after the injection, the temperature may rise and a pale pink rash may appear.

    One of the most difficult vaccinations is DPT – vaccination against tetanus, pertussis and diphtheria.In 15-20% of cases, after vaccination, there is an increase in body temperature, loss of appetite, general malaise, irritability and drowsiness.

    Reactions to vaccinations are an individual characteristic of the organism. As a rule, the effects of the introduction of the vaccine disappear within two to three days. It is important to understand that small changes in well-being and behavior are normal, and vaccinations protect the body from serious diseases in the future.

    Why cluster headaches come with autumn

    The head can split even from… contraceptives

    Today it is customary to attribute all diseases to stress, bad ecology, wrong way of life. And you can’t argue with that. But as for cluster headaches, there are many other reasons. More and more people suffer from them every year. And thanks to research, it became clear that such pains are associated not only with the environment, stress, physical inactivity, although this is very important. More and more neurologists are inclined to blame for this universal computerization, which has engulfed all of humanity: our thoughts, feelings, and most importantly, time.

    Indeed, the World Wide Web is drawing more and more people into its virtual networks, and the age of fans has already dropped below the lowest level – to kindergarten. Even the concept of “computer addiction” has become habitual – a person’s pathological addiction to spending time at the computer. In fact, this is a psychological dependence, which manifests itself in an obsessive passion for information posted on the Internet, video and computer games. And this new disease primarily affects the young part of the population, mainly adolescents.And when the head is unable to digest such a huge stream of information, it just splits.

    This is not the only reason for cluster headaches. She can split from overexertion at work, and from a large number of drugs, in particular hormonal, contraceptive, and even from … pain relievers. And also – from the immeasurable addiction to smoking, alcohol, chaotic eating, etc. Therefore, it may be enough for someone to change their lifestyle, type of diet, reduce zeal at work, give up bad habits – and the pain will recede.But some do not …


    Today, even medications can cause headaches. Among them, oddly enough, are over-the-counter pain relievers (aspirin, analgin, etc., taken more than twice a week), drugs for lowering blood pressure, for the treatment of angina pectoris and ulcers, narcotic and even contraceptives.

    – The so-called cluster headaches occur suddenly, in a series of seizures (clusters, hence the name), – explained the leading researcher of the group of clinical pathology of cerebral circulation of the N.N.N.N.Burdenko, neurologist of the highest category Viktor SHAKHNOVICH . – They can pester a person several times a day for several days or even weeks. They do not last long and just as suddenly subside. What is the reason for this? The symptoms and timing of the onset of such pain indicate that it is more of a cyclic disorder. Most often, cluster headaches occur at the same time of day, mainly in autumn or spring. Therefore, many experts associate this syndrome with a person’s biological clock.

    This is evidenced by the cyclical nature of their appearance. It has been noticed: nocturnal attacks of cluster pain in half of cases occur in the phase of REM sleep, when a person sees dreams.


    ■ cluster pain occurs more often at night;

    ■ seizures are localized on one side of the face;

    ■ they are very painful, but short, follow each other;

    ■ the face may be flushed with a rush of blood, and the forehead may be covered with perspiration;

    ■ eyes may turn red and tears may appear;

    ■ the eyelid on the affected side is drooping and may appear swollen;

    ■ stuffy nose;

    ■ the pupil is temporarily narrowed, the perception of the world may be blurry;

    – rapid heartbeat.

    Pathology, fortunately, is not inherited.

    Migraines and “computer” pain have their own habits

    But the most common type of headache is still migraine, the expert said. Although it also affects only one side of the head or some part of it, such as the temple. By the way, the very word “migraine” means “malaise of half of the head.” It is mainly associated with the expansion of blood vessels. And among the symptoms – not only headache, but also nausea, vomiting, dizziness, numbness and even visual disturbances.

    And in migraine, as studies have shown, women are in the lead – they make up 75%. And the predisposition to it, in contrast to cluster pain, is inherited.

    There is also the pain of tension – many call it computer pain. This pain is bilateral and migratory: more often it is localized in the forehead or occiput, sometimes in the neck and shoulders. It is also a very common type of this pathology. Experts often call it the pain of muscle contraction, linking its appearance with stress.And for some people it becomes a chronic ailment. In other words, these headaches do not have migraine-like symptoms and are not associated with any underlying disease.

    Emotional factors are of great importance in the occurrence of such headaches, but they are not the only ones, our expert believes. These pains can be caused, for example, by a forced posture, or an uncomfortable position of the neck when driving for a long time in a car, or a long stay at the TV, working at a computer, long reading, etc.All this can provoke tension headaches, since the neck is often in a tense position, the chin is close to the chest. Even talking on the phone with the receiver pressed against your ear with your shoulder can also cause muscle tension.

    Symptom of migraine and tension pain – constricting, pressing sensation in the head.


    Studies have shown that 94% of headache sufferers are heavy smokers, and many of them started smoking as adolescents or adolescents.Experts associate this hobby with their propensity to abuse alcohol. During an exacerbation, it is better to give up alcohol and reduce smoking – this can provoke an even stronger vasospasm.

    Specific features of women are to blame …

    I would like to understand: why today women are the biggest sufferers of headaches? And why did they seize the initiative from the stronger sex when it comes to cluster pain? Perhaps because today they want to be no worse than men in everything, and in many areas they are already leading.Today they are more likely to experience headaches, be they cluster, migraine, tension or stress pain.

    Is this the payback? What they fought for … Perhaps. But in women, a headache can also be provoked by the specific characteristics of their body, our expert believes. Hormonal changes follow them throughout their lives. In childbearing age, severe headaches can bother a few days before menstruation, which, however, disappear with the onset of the cycle. Experts qualify these pains as a manifestation of premenstrual syndrome associated with a sharp drop in estrogen.And hormone therapy is recommended. In addition, chocolate and caffeinated drinks should be avoided during the premenstrual period.

    During pregnancy, when the hormonal background stabilizes, women do not bother with headaches. But with the advent of menopause, a complex hormonal change again occurs in the female body. The climacteric period is difficult for many women, and at this time prolonged headaches can occur.

    During persistent menopause, many doctors also recommend that women take hormonal drugs.However, these drugs themselves can provoke attacks of headaches, as, by the way, hormonal contraceptives.

    “Do not tolerate a headache – it destroys brain cells” (advice from neurologists)

    Get enough sleep. It has long been known that sleep is the best medicine. To all, without exception, people experiencing headaches, experts recommend getting enough sleep. A person should spend a third of his life in a dream. Such a long rest is necessary to restore physical and other strength.But today there are many who sleep little for days, weeks and even years (for various reasons). And even proud of it. But they hurt themselves a lot – their sleep balance is disturbed. The simplest rules will help to normalize the situation: do not drink coffee or stimulating drinks before bedtime; avoiding alcohol at night; stay awake during the day. If sleep still does not come, you should not suffer: you need to get out of bed and do something.

    Increase physical activity. During the daily exercise, the most important processes occur inside the body: the metabolic rate increases, fat is burned, calories are destroyed, and the cardiovascular system is strengthened.All this will help people suffering from headaches.

    Eat right. You need to reduce the amount of meat in your menu, which consists mainly of fats and protein, which can serve as a provoking factor for migraine attacks.

    Maintain magnesium. Alcohol and prolonged stress can reduce the amount of this trace element in the body. In addition to headaches, symptoms of its reduction are muscle cramps, general fatigue, sleep disturbance and irritability.Experts strongly recommend that patients include magnesium-rich foods in their diet – nuts, beans, whole grains, fish. Magnesium prevents blood vessel spasms. It can also be taken as a pill.


    ■ Applying ice to the base of the skull is a very effective remedy for headaches, especially in an acute migraine attack;

    ■ use special headbands made of elastic tape;

    ■ massage will help in combination with the thermal method, focusing on the areas of greatest muscle tension and spasm;

    ■ use the correct breathing technique: breathe slowly and evenly, deeply, mentally concentrating on the abdominal muscles;

    ■ Relaxation: Take a deep breath for a count of 8.Then purse your lips and inhale slowly until a count of 16 or longer while you can;

    ■ homeopathy: small doses of belladonna will help treat migraines; from “caffeine” headaches will save the emetic root. But you need to know that in large doses they can be poisoned. Therefore, a doctor’s consultation is imperative;

    ■ sex – in some cases it helps to get rid of headaches, and in some cases it even cures;

    ■ fish oil: taken for 6 weeks or more, it significantly reduces the number of headaches, especially with migraines.Experts associate its effect with a decrease in the release of serotonin, a pain mediator.

    … Pain is the watchdog of health, the ancient Greeks said. You can’t say more precisely. Any pain, including a headache, is a signal for action, according to modern neurologists. She informs the person that something is wrong in his body.

    Of course, any headache is not a gift, modern experts summarize. But today, with a suspicion of its organic nature, doctors use X-ray of the skull, angiography and electroencephalography, CT and MRI of the vessels of the brain.