Wednesday, March 23, 2011

Oh My Aching Head!

Most of us have experienced a headache at some point in our lives. Some of us more frequently than others. Figuring what is causing a patient’s head to hurt is enough to give a physician a headache.

The differential diagnosis for head pain ranges from trauma to tumor to tooth to tension to tryptamines. There are many more causes of a headache but they do not conveniently begin with the letter “T.” A sudden onset severe headache with no previous history of headache is usually cause to visit an emergency department. The root of chronic headaches is more complicated.

One of the best ways to help your physician find the cause of your pain is to keep a headache diary. A good example is available at

For women it is important to note where you are in your menstrual cycle. Migraines in particular have been related to low progesterone and other hormonal imbalances. Also note water consumption, environmental exposure (cleaning chemicals, dry cleaning, insecticides) and foods.

One of the most common causes of headache is dehydration. If your headaches come about the same time every afternoon, check to make sure you are drinking half your body weight in ounces of water. Withdrawal headaches are common with caffeine and sugar users. When the brain is deprived of the level of these that it is accustomed to, the result is a headache. If the headache resolves with coffee or sugar, it is time to wean off.

True headaches fall into three broad categories: tension, cluster, migraine. Tension headaches are common to both men and women, occur daily, and are a dull steady ache over the whole head. Cluster headaches usually occur in men, happen once a week, last less than four hours, are one sided and are severe in pain (think being stabbed in the head with an ice pick.) Migraines are more common in women, occur less frequently, can be one or both sided, can last 72 hours and are moderate in pain level. Migraines are further divided into classic, common and complicated. Classic have an aura or prodrome that let’s the victim know it is about to attack. Common lacks this feature. Complicated has sensory and motor impairments with the headache. And all three types of headaches can trigger each other.

The mouth can be a headache in and of itself. TMJ, grinding the teeth, root canal issues, and poor gum health can all lead to headaches. Sinus congestion can also manifest as a headache. Malposition of the spine can lead to headaches as well as somatic dysfunction. A common description of a headache is starting at the base of the skull and radiating behind the eye. This is usually caused by an over-used splenius capitis muscle and injection therapy or physical medicine is often the best solution.

The treatment of headaches is as varied as the causes of headaches. Avoiding triggers, balancing hormones and maintaining proper hydration are good starting points. And while you and your physician are looking for the source of your headaches, the World Health Organization recognizes acupuncture as an effective treatment for symptomatic relief of headaches.

Thursday, March 3, 2011

The Heart of the Matter

This year at NFC we are putting more emphasis on patient education and providing events and other gatherings where patients and the community as a whole can not only receive education from health professionals but have a chance to connect with other individuals who might share in their health concerns.

This month we have Dr. Marie hosting a FREE BREAKFAST and FREE Cardiovascular lab testing Saturday, March 5th starting at 8am. Blood draws 8-9, breakfast starting at 8:15 and health lecture starting at 9am. Dr. Marie will also be hosting a free health lecture titled, Oh, My Aching Head! Thursday, March 24th 6pm at NFC. Space is limited so please call 602.493.2273 to RSVP.

To keep up to date on all the events at NFC visit our facebook page.

Cholesterol – It is more than just a number
Marie Niechwiadowicz, NMD

Patient 1 has his blood work run and his total cholesterol is 182. Patient 2 has hers run and it is 232. We are told that total cholesterol should be less than 200. Who has healthier cholesterol levels and less risk for heart disease?

Trick question – without breaking down the total number into LDL, VLDL and HDL the number is useless.

Quick definitions:
– high density lipoprotein. Considered to be protective against heart disease – often called the “good cholesterol.” The higher the number the better. Should be at least 45.
LDL – low density lipoprotein. Causes the formation of arterial plaque – the “bad cholesterol.” Should be less than 130, less than 100 is optimal.
VLDL - very low density lipoprotein. Considered even worse than LDL as a cardiac risk factor. Should be less than 29.

Back to the patients numbers:
Patient 1 HDL 12, LDL 135, VLDL 35 = Total Cholesterol 182
Patient 2 HDL 142 LDL 85, VLDL 5 = Total Cholesterol 232

Obviously Patient 2 has a much lower risk for heart disease even though her total cholesterol would be considered high. Interestingly, half of the people who have heart attacks have “normal” cholesterol levels.

There is more…
Trigylcerides, apolipoprotien, the size and the density of the LDL, remnant lipoprotein, homocysteine levels, c-reactive proteins, and insulin resistance all contribute to your risk of heart disease -- even more so than VLDL and LDL. These factors indicate when the conditions are most conducive to creating arterial plaque.

So why do we need cholesterol? Cholesterol is the building block for our hormones – estrogen, progesterone, testosterone, aldosterone, and cortisol are all made from cholesterol. It is possible to have too little cholesterol especially through over supplementation/medication.

Bloodwork is available to test all these risk factors in addition to the HDL, LDL and Total cholesterol. These labs are a valuable tool since the strategy to reduce one risk factor is different for another. Diet and exercise should be the first line of therapy to reduce cardiac risk factors. As always, good medicine is not one supplement/drug fits all. Attend our talk March 5th to learn about your cardiac risk factors and create a plan to optimize your heart health.