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Readers response: What’s your best advice for managing medications while travelling?

<p>When taking a trip, many people often have to factor in how their changing schedule will affect their regular medication routines. </p> <p>We asked our readers for their best advice on managing medications while travelling, and the response was overwhelming. Here's what they said. </p> <p><strong>Kristeen Bon</strong> - I put each days tablet into small ziplock bags and staple them at one corner. All that goes into one larger ziplock bag and into my toilet bag. I store all the outer packs flat into another ziplock bag and that stays in the zip pack with my first aid kit in the main suitcase. I travel long haul up to six times a year and this is the most manageable way I have found.</p> <p><strong>Diane Green</strong> - Firstly, take sufficient  supply of all meds to last the time I'm away. I separate morning medications and evening medications. Then it depends on how long I'm away. I have one that needs to be refrigerated. Depending on where I travel, this can entail arranging overnight in the establishment fridge while taking a freezer pack for daytime travel.</p> <p><strong>Irene Varis</strong> - Always get a letter from my doctor, with all my prescriptions for when I get overseas. Saves you a lot of trouble!</p> <p><strong>Helen Lunn</strong> - Just get the chemist to pack into Medipacks. I usually take an extra week. I alway put some of the packs in my partners baggage incase my bag goes missing and a pack and a doctor’s letter in my hand luggage.</p> <p><strong>Jancye Winter</strong> - Always pack in your carry on with prescriptions.</p> <p><strong>Jenny Gordon</strong> - Carry a letter from doc with all medications, leave in original packaging. Double check that it isn’t illegal to carry your medication as some countries have strict regulations for things like Codeine. Always carry in carry on as you don’t want them to get lost.</p> <p><strong>Nina Thomas Rogers</strong> - Be organised with all your medicines before you leave.</p> <p><em>Image credits: Shutterstock </em></p>

Travel Tips

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Woman “bullied” on plane over budget seating trick

<p dir="ltr">A young woman has recalled a flight from hell when she was “bullied” by a couple who were trying to utilise a seating hack that went viral on TikTok. </p> <p dir="ltr">The solo traveller took to Reddit to recount the story and ask social media users if she was in the wrong for her action. </p> <p dir="ltr">The woman began by saying she usually pays more to select her plane seat ahead of time, but a medical emergency on another plane had her waiting on standby and left with no option other than to sit in a middle seat.</p> <p dir="ltr">When she was finally able to board, she was greeted by a couple who had purchased both the window and aisle seats in a bid to have more space, utilising a travel “trick” that has been popular on TikTok.</p> <p dir="ltr">The method, which has been dubbed the 'poor man's business class', usually leaves travellers with an empty middle seat and more space, and few travellers opt to pick a middle seat. </p> <p dir="ltr">“When I got to my row the man and woman were chatting and sharing a snack... it was obvious they were together. I mentioned to the man that I'm in the middle, and he got up to let me in,” the unsuspecting traveller wrote on Reddit.  </p> <p dir="ltr">“I asked them if they would prefer to sit together, I said I was totally okay with that. The woman reacted rudely to this and said ‘you're not supposed to be sitting here anyway’.”</p> <p dir="ltr">After noticing how the plane was full, she offered to show the pair her new ticket with the correct seat number on it.</p> <p dir="ltr">“She flicked her hand at my ticket and made a disgusted sound. I offered again if they wanted to sit together to which she didn't reply, her partner said it's okay and... made some small talk,” she continued. </p> <p dir="ltr">The man’s girlfriend then interrupted their conversation to ask,”'Did you use one of those third party websites to book your flight? It's so frustrating when people cheap out to inconvenience others.”</p> <p dir="ltr">The American woman explained that she had booked her flight directly and she had been placed on standby like everyone else and didn't choose the middle seat - she was assigned it.</p> <p dir="ltr">She then tried to keep the peace by refusing to engage with the furious woman.  </p> <p dir="ltr">“I was so done with her attitude, I put my headphones on and attempted to do my own thing,” she explained.</p> <p dir="ltr">But the “entitled” girlfriend wasn't letting it go, as the woman explained, “This woman kept reaching over me and tapping her partner and trying to talk to him in a way that was super intrusive.”</p> <p dir="ltr">“I could tell even her partner was trying to engage her less so that she would hopefully stop, but she didn't.”</p> <p dir="ltr">“I think they tried to pull that tactic where they don't sit together on purpose...hoping no one will sit between them. But on full flights it doesn't work. And even so - it's not the other person's fault.”</p> <p dir="ltr">The traveller's post was met with hundreds of comments slamming the girlfriend’s behaviour, as one person wrote, “It's like a toddler having a tantrum.”</p> <p dir="ltr">“She was disappointed and a total a**hole. Gross entitled people,” another added. </p> <p dir="ltr">Another person applauded the traveller’s level-headed behaviour, writing, “Wow! You are my hero for keeping it classy - I’m afraid I would not have been as kind as you.”</p> <p dir="ltr"><em>Image credits: Shutterstock </em></p>

Travel Trouble

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What happens in my brain when I get a migraine? And what medications can I use to treat it?

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/mark-slee-1343982">Mark Slee</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> and <a href="https://theconversation.com/profiles/anthony-khoo-1525617">Anthony Khoo</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a></em></p> <p>Migraine is many things, but one thing it’s not is “just a headache”.</p> <p>“Migraine” <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1029040/">comes from</a> the Greek word “hemicrania”, referring to the common experience of migraine being predominantly one-sided.</p> <p>Some people experience an “aura” preceding the headache phase – usually a visual or sensory experience that evolves over five to 60 minutes. Auras can also involve other domains such as language, smell and limb function.</p> <p>Migraine is a disease with a <a href="https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(18)30322-3/fulltext">huge personal and societal impact</a>. Most people cannot function at their usual level during a migraine, and anticipation of the next attack can affect productivity, relationships and a person’s mental health.</p> <h2>What’s happening in my brain?</h2> <p>The biological basis of migraine is complex, and varies according to the phase of the migraine. Put simply:</p> <p>The earliest phase is called the <strong>prodrome</strong>. This is associated with activation of a part of the brain called the hypothalamus which is thought to contribute to many symptoms such as nausea, changes in appetite and blurred vision.</p> <figure class="align-center "><img src="https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=485&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=485&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=485&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=610&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=610&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=610&amp;fit=crop&amp;dpr=3 2262w" alt="" /><figcaption><span class="caption">The hypothalamus is shown here in red.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-vector/brain-cross-section-showing-basal-ganglia-329843930">Blamb/Shutterstock</a></span></figcaption></figure> <p>Next is the <strong>aura phase</strong>, when a wave of neurochemical changes occur across the surface of the brain (the cortex) at a rate of 3–4 millimetres per minute. This explains how usually a person’s aura progresses over time. People often experience sensory disturbances such as flashes of light or tingling in their face or hands.</p> <p>In the <strong>headache phase</strong>, the trigeminal nerve system is activated. This gives sensation to one side of the face, head and upper neck, leading to release of proteins such as CGRP (calcitonin gene-related peptide). This causes inflammation and dilation of blood vessels, which is the basis for the severe throbbing pain associated with the headache.</p> <p>Finally, the <strong>postdromal phase</strong> occurs after the headache resolves and commonly involves changes in mood and energy.</p> <h2>What can you do about the acute attack?</h2> <p>A useful way to conceive of <a href="https://www.migraine.org.au/factsheets">migraine treatment</a> is to compare putting out campfires with bushfires. Medications are much more successful when applied at the earliest opportunity (the campfire). When the attack is fully evolved (into a bushfire), medications have a much more modest effect.</p> <p><iframe id="Pj1sC" class="tc-infographic-datawrapper" style="border: 0;" src="https://datawrapper.dwcdn.net/Pj1sC/" width="100%" height="400px" frameborder="0" scrolling="no"></iframe></p> <p><strong>Aspirin</strong></p> <p>For people with mild migraine, non-specific anti-inflammatory medications such as high-dose aspirin, or standard dose non-steroidal medications (NSAIDS) can be very helpful. Their effectiveness is often enhanced with the use of an anti-nausea medication.</p> <p><strong>Triptans</strong></p> <p>For moderate to severe attacks, the mainstay of treatment is a class of medications called “<a href="https://assets.nationbuilder.com/migraineaus/pages/595/attachments/original/1678146819/Factsheet_15_2023.pdf?1678146819">triptans</a>”. These act by reducing blood vessel dilation and reducing the release of inflammatory chemicals.</p> <p>Triptans vary by their route of administration (tablets, wafers, injections, nasal sprays) and by their time to onset and duration of action.</p> <p>The choice of a triptan depends on many factors including whether nausea and vomiting is prominent (consider a dissolving wafer or an injection) or patient tolerability (consider choosing one with a slower onset and offset of action).</p> <p>As triptans constrict blood vessels, they should be used with caution (or not used) in patients with known heart disease or previous stroke.</p> <p><strong>Gepants</strong></p> <p>Some medications that block or modulate the release of CGRP, which are used for migraine prevention (which we’ll discuss in more detail below), also have evidence of benefit in treating the acute attack. This class of medication is known as the “gepants”.</p> <p>Gepants come in the form of injectable proteins (monoclonal antibodies, used for migraine prevention) or as oral medication (for example, rimegepant) for the acute attack when a person has not responded adequately to previous trials of several triptans or is intolerant of them.</p> <p>They do not cause blood vessel constriction and can be used in patients with heart disease or previous stroke.</p> <p><strong>Ditans</strong></p> <p>Another class of medication, the “ditans” (for example, lasmiditan) have been approved overseas for the acute treatment of migraine. Ditans work through changing a form of serotonin receptor involved in the brain chemical changes associated with the acute attack.</p> <p>However, neither the gepants nor the ditans are available through the Pharmaceutical Benefits Scheme (PBS) for the acute attack, so users must pay out-of-pocket, at a <a href="https://www.migraine.org.au/cgrp#:%7E:text=While%20the%20price%20of%20Nurtec,%2D%24300%20per%208%20wafers.">cost</a> of approximately A$300 for eight wafers.</p> <h2>What about preventing migraines?</h2> <p>The first step is to see if <a href="https://assets.nationbuilder.com/migraineaus/pages/595/attachments/original/1677043428/Factsheet_5_2023.pdf?1677043428">lifestyle changes</a> can reduce migraine frequency. This can include improving sleep habits, routine meal schedules, regular exercise, limiting caffeine intake and avoiding triggers such as stress or alcohol.</p> <p>Despite these efforts, many people continue to have frequent migraines that can’t be managed by acute therapies alone. The choice of when to start preventive treatment varies for each person and how inclined they are to taking regular medication. Those who suffer disabling symptoms or experience more than a few migraines a month <a href="https://www.nejm.org/doi/full/10.1056/NEJMra1915327">benefit the most</a> from starting preventives.</p> <p>Almost all migraine <a href="https://assets.nationbuilder.com/migraineaus/pages/595/attachments/original/1708566656/Factsheet_16_2024.pdf?1708566656">preventives</a> have existing roles in treating other medical conditions, and the physician would commonly recommend drugs that can also help manage any pre-existing conditions. First-line preventives include:</p> <ul> <li>tablets that lower blood pressure (candesartan, metoprolol, propranolol)</li> <li>antidepressants (amitriptyline, venlafaxine)</li> <li>anticonvulsants (sodium valproate, topiramate).</li> </ul> <p>Some people have none of these other conditions and can safely start medications for migraine prophylaxis alone.</p> <p>For all migraine preventives, a key principle is starting at a low dose and increasing gradually. This approach makes them more tolerable and it’s often several weeks or months until an effective dose (usually 2- to 3-times the starting dose) is reached.</p> <p>It is rare for noticeable benefits to be seen immediately, but with time these drugs <a href="https://pubmed.ncbi.nlm.nih.gov/26252585/">typically reduce</a> migraine frequency by 50% or more.</p> <hr /> <p><iframe id="jxajY" class="tc-infographic-datawrapper" style="border: 0;" src="https://datawrapper.dwcdn.net/jxajY/" width="100%" height="400px" frameborder="0" scrolling="no"></iframe></p> <hr /> <h2>‘Nothing works for me!’</h2> <p>In people who didn’t see any effect of (or couldn’t tolerate) first-line preventives, new medications have been available on the PBS since 2020. These medications <a href="https://pubmed.ncbi.nlm.nih.gov/8388188/">block</a> the action of CGRP.</p> <p>The most common PBS-listed <a href="https://assets.nationbuilder.com/migraineaus/pages/595/attachments/original/1708566656/Factsheet_16_2024.pdf?1708566656">anti-CGRP medications</a> are injectable proteins called monoclonal antibodies (for example, galcanezumab and fremanezumab), and are self-administered by monthly injections.</p> <p>These drugs have quickly become a game-changer for those with intractable migraines. The convenience of these injectables contrast with botulinum toxin injections (also <a href="https://www.migraine.org.au/botox">effective</a> and PBS-listed for chronic migraine) which must be administered by a trained specialist.</p> <p>Up to half of adolescents and one-third of young adults are <a href="https://deepblue.lib.umich.edu/bitstream/handle/2027.42/147205/jan13818.pdf">needle-phobic</a>. If this includes you, tablet-form CGRP antagonists for migraine prevention are hopefully not far away.</p> <p>Data over the past five years <a href="https://pubmed.ncbi.nlm.nih.gov/36718044/">suggest</a> anti-CGRP medications are safe, effective and at least as well tolerated as traditional preventives.</p> <p>Nonetheless, these are used only after a number of cheaper and more readily available <a href="https://assets.nationbuilder.com/migraineaus/pages/595/attachments/original/1677043425/Factsheet_2_2023.pdf?1677043425">first-line treatments</a> (all which have decades of safety data) have failed, and this also a criterion for their use under the PBS.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/227559/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/mark-slee-1343982">Mark Slee</a>, Associate Professor, Clinical Academic Neurologist, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> and <a href="https://theconversation.com/profiles/anthony-khoo-1525617">Anthony Khoo</a>, Lecturer, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-happens-in-my-brain-when-i-get-a-migraine-and-what-medications-can-i-use-to-treat-it-227559">original article</a>.</em></p> </div>

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Taking too many medications can pose health risks. Here’s how to avoid them

<p><em><a href="https://theconversation.com/profiles/caroline-sirois-1524891">Caroline Sirois</a>, <a href="https://theconversation.com/institutions/universite-laval-1407">Université Laval</a></em></p> <p>When we see an older family member handling a bulky box of medications sorted by day of the week, we might stop and wonder, is it too much? How do all those pills interact?</p> <p>The fact is, as we get older we are more likely to develop different chronic illnesses that require us to take several different medications. This is known as polypharmacy. The concept applies to people taking five or more medications, but there are all sorts of <a href="https://doi.org/10.3390/pharmacy7030126">definitions with different thresholds</a> (for example, four, 10 or 15 medicines).</p> <p>I’m a pharmacist and pharmacoepidemiologist interested in polypharmacy and its impact on the population. The research I carry out with my team at the Faculty of Pharmacy at Université Laval focuses on the appropriate use of medication by older family members. We have published this <a href="https://doi.org/10.1093/ageing/afac244">study</a> on the perceptions of older adults, family carers and clinicians on the use of medication among persons over 65.</p> <h2>Polypharmacy among older adults</h2> <p>Polypharmacy is very common among older adults. In 2021, a quarter of persons over 65 in Canada were prescribed <a href="https://www.cihi.ca/en/drug-use-among-seniors-in-canada">more than ten different classes of medication</a>. In Québec, persons over 65 used an average of <a href="https://www.inspq.qc.ca/sites/default/files/publications/2679_portrait_polypharmacie_aines_quebecois.pdf">8.7 different drugs in 2016</a>, the latest year available for statistics.</p> <p>Is it a good idea to take so many drugs?</p> <p>According to <a href="https://journals.sagepub.com/doi/10.1177/07334648211069553">our study</a>, the vast majority of seniors and family caregivers would be willing to stop taking one or more medications if the doctor said it was possible, even though most are satisfied with their treatments, <a href="https://doi.org/10.1093/ageing/afac244">have confidence in their doctors</a> and feel that their doctors are taking care of them to the best of their ability.</p> <p>In the majority of cases, medicine prescribers are helping the person they are treating. Medications have a positive impact on health and are essential in many cases. But while the treatment of individual illnesses is often adequate, the whole package can sometimes become problematic.</p> <h2>The risks of polypharmacy: 5 points to consider</h2> <p>When we evaluate cases of polypharmacy, we find that the quality of treatment is often compromised when many medications are being taken.</p> <ol> <li> <p>Drug interactions: polypharmacy increases the risk of drugs interacting, which can lead to undesirable effects or reduce the effectiveness of treatments.</p> </li> <li> <p>A drug that has a positive effect on one illness may have a negative effect on another: what should you do if someone has both illnesses?</p> </li> <li> <p>The greater the number of drugs taken, the greater the risk of undesirable effects: for adults over 65, for example, there is an increased risk of confusion or falls, which have significant consequences.</p> </li> <li> <p>The more medications a person takes, the more likely they are to take a <a href="https://www.doi.org/10.1093/fampra/cmz060">potentially inappropriate medication</a>. For seniors, these drugs generally carry more risks than benefits. For example, benzodiazepines, medicine for anxiety or sleep, are the <a href="https://www.inspq.qc.ca/sites/default/files/publications/2575_utilisation_medicaments_potentiellement_inappropries_aines.pdf">most frequently used class</a> of medications. We want to reduce their use as much as possible <a href="https://www.canada.ca/en/health-canada/services/substance-use/controlled-illegal-drugs/benzodiazepines.html">to avoid negative impacts</a> such as confusion and increased risk of falls and car accidents, not to mention the risk of dependence and death.</p> </li> <li> <p>Finally, polypharmacy is associated with various adverse health effects, such as an <a href="https://www.doi.org/10.1007/s41999-021-00479-3">increase in frailty, hospital admissions and emergency room visits</a>. However, studies conducted to date have not always succeeded in isolating the effects specific to polypharmacy. As polypharmacy is more common among people with multiple illnesses, these illnesses may also contribute to the observed risks.</p> </li> </ol> <p>Polypharmacy is also a combination of medicines. There are almost as many as there are people. The risks of these different combinations can vary. For example, the risks associated with a combination of five potentially inappropriate drugs would certainly be different from those associated with blood pressure medication and vitamin supplements.</p> <p>Polypharmacy is therefore complex. <a href="https://doi.org/10.1186/s12911-021-01583-x">Our studies attempt to use artificial intelligence</a> to manage this complexity and identify combinations associated with negative impacts. There is still a lot to learn about polypharmacy and its impact on health.</p> <h2>3 tips to avoid the risks associated with polypharmacy</h2> <p>What can we do as a patient, or as a caregiver?</p> <ol> <li> <p>Ask questions: when you or someone close to you is prescribed a new treatment, be curious. What are the benefits of the medication? What are the possible side effects? Does this fit in with my treatment goals and values? How long should this treatment last? Are there any circumstances in which discontinuing it should be considered ?</p> </li> <li> <p>Keep your medicines up to date: make sure they are all still useful. Are there still any benefits to taking them? Are there any side effects? Are there any drug interactions? Would another treatment be better? Should the dose be reduced?</p> </li> <li> <p>Think about de-prescribing: this is an increasingly common clinical practice that involves stopping or reducing the dose of an inappropriate drug after consulting a health-care professional. It is a shared decision-making process that involves the patient, their family and health-care professionals. The <a href="https://www.deprescribingnetwork.ca">Canadian Medication Appropriateness and Deprescribing Network</a> is a world leader in this practice. It has compiled a number of tools for patients and clinicians. You can find them on their website and subscribe to the newsletter.</p> </li> </ol> <h2>Benefits should outweigh the risks</h2> <p>Medications are very useful for staying healthy. It’s not uncommon for us to have to take more medications as we age, but this shouldn’t be seen as a foregone conclusion.</p> <p>Every medication we take must have direct or future benefits that outweigh the risks associated with them. As with many other issues, when it comes to polypharmacy, the saying, “everything in moderation,” frequently applies.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/230612/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/caroline-sirois-1524891">Caroline Sirois</a>, Professor in Pharmacy, <a href="https://theconversation.com/institutions/universite-laval-1407">Université Laval</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/taking-too-many-medications-can-pose-health-risks-heres-how-to-avoid-them-230612">original article</a>.</em></p>

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Asking ChatGPT a health-related question? Better keep it simple

<p>It’s tempting to <a href="https://cosmosmagazine.com/news/chatgpt-and-dr-google/">turn to search engines</a> to seek out health information, but with the rise of large language models, like ChatGPT, people are becoming more and more likely to depend on AI for answers too.</p> <div class="copy"> <p>Concerningly, an Australian study has now found that the more evidence given to <a href="https://cosmosmagazine.com/technology/chatgpt-an-intimate-companion/">ChatGPT</a> when asked a health-related question, the less reliable it becomes.</p> <p>Large language models (LLM) and artificial intelligence use in health care is still developing, creating a  a critical gap when providing incorrect answers can have serious consequences for people’s health.</p> <p>To address this, scientists from Australia’s national science agency, CSIRO, and the University of Queensland (UQ) explored a hypothetical scenario: an average person asking ChatGPT if ‘X’ treatment has a positive effect on condition ‘Y’.</p> <p>They presented ChatGPT with 100 questions sourced from the <a href="https://trec-health-misinfo.github.io/" target="_blank" rel="noopener">TREC Health Misinformation track</a> – ranging from ‘Can zinc help treat the common cold?’ to ‘Will drinking vinegar dissolve a stuck fish bone?’</p> <p>Because queries to search engines are typically shorter, while prompts to a LLM can be far longer, they posed the questions in 2 different formats: the first as a simple question and the second as a question biased with supporting or contrary evidence.</p> <p>By comparing ChatGPT’s response to the known correct response based on existing medical knowledge, they found that ChatGPT was 80% accurate at giving accurate answers in a question-only format. However, when given an evidence-biased prompt, this accuracy reduced to 63%, which was reduced again to 28% when an “unsure” answer was allowed. </p> <p>“We’re not sure why this happens,” says CSIRO Principal Research Scientist and Associate Professor at UQ, Dr Bevan Koopman, who is co-author of the paper.</p> <p>“But given this occurs whether the evidence given is correct or not, perhaps the evidence adds too much noise, thus lowering accuracy.”</p> <p>Study co-author Guido Zuccon, Director of AI for the Queensland Digital Health Centre at UQ says that major search engines are now integrating LLMs and search technologies in a process called Retrieval Augmented Generation.</p> <p>“We demonstrate that the interaction between the LLM and the search component is still poorly understood, resulting in the generation of inaccurate health information,” says Zuccon.</p> <p>Given the widespread popularity of using LLMs online for answers on people’s health, Koopman adds, we need continued research to inform the public about risks and to help them optimise the accuracy of their answers.</p> <p>“While LLMs have the potential to greatly improve the way people access information, we need more research to understand where they are effective and where they are not.”</p> <p><em>Image credits: Getty Images</em></p> <div> <p align="center"> </p> </div> <p><em><img id="cosmos-post-tracker" style="opacity: 0; height: 1px!important; width: 1px!important; border: 0!important; position: absolute!important; z-index: -1!important;" src="https://syndication.cosmosmagazine.com/?id=301406&amp;title=Asking+ChatGPT+a+health-related+question%3F+Better+keep+it+simple" width="1" height="1" loading="lazy" aria-label="Syndication Tracker" data-spai-target="src" data-spai-orig="" data-spai-exclude="nocdn" /></em><em><a href="https://cosmosmagazine.com/technology/ai/asking-chatgpt-a-health-related-question-better-keep-it-simple/">This article</a> was originally published on <a href="https://cosmosmagazine.com">Cosmos Magazine</a> and was written by <a href="https://cosmosmagazine.com/contributor/imma-perfetto/">Imma Perfetto</a>. </em></div>

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Why it’s a bad idea to mix alcohol with some medications

<p><em><a href="https://theconversation.com/profiles/nial-wheate-96839">Nial Wheate</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/jasmine-lee-1507733">Jasmine Lee</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/kellie-charles-1309061">Kellie Charles</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/tina-hinton-329706">Tina Hinton</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p>Anyone who has drunk alcohol will be familiar with how easily it can lower your social inhibitions and let you do things you wouldn’t normally do.</p> <p>But you may not be aware that mixing certain medicines with alcohol can increase the effects and put you at risk.</p> <p>When you mix alcohol with medicines, whether prescription or over-the-counter, the medicines can increase the effects of the alcohol or the alcohol can increase the side-effects of the drug. Sometimes it can also result in all new side-effects.</p> <h2>How alcohol and medicines interact</h2> <p>The chemicals in your brain maintain a delicate balance between excitation and inhibition. Too much excitation can lead to <a href="https://www.medicalnewstoday.com/articles/324330">convulsions</a>. Too much inhibition and you will experience effects like sedation and depression.</p> <p><iframe id="JCh01" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/JCh01/1/" width="100%" height="400px" frameborder="0"></iframe></p> <p>Alcohol works by increasing the amount of inhibition in the brain. You might recognise this as a sense of relaxation and a lowering of social inhibitions when you’ve had a couple of alcoholic drinks.</p> <p>With even more alcohol, you will notice you can’t coordinate your muscles as well, you might slur your speech, become dizzy, forget things that have happened, and even fall asleep.</p> <p>Medications can interact with alcohol to <a href="https://awspntest.apa.org/record/2022-33281-033">produce different or increased effects</a>. Alcohol can interfere with the way a medicine works in the body, or it can interfere with the way a medicine is absorbed from the stomach. If your medicine has similar side-effects as being drunk, those <a href="https://www.drugs.com/article/medications-and-alcohol.html#:%7E:text=Additive%20effects%20of%20alcohol%20and,of%20drug%20in%20the%20bloodstream.">effects can be compounded</a>.</p> <p>Not all the side-effects need to be alcohol-like. Mixing alcohol with the ADHD medicine ritalin, for example, can <a href="https://www.healthline.com/health/adhd/ritalin-and-alcohol#side-effects">increase the drug’s effect on the heart</a>, increasing your heart rate and the risk of a heart attack.</p> <p>Combining alcohol with ibuprofen can lead to a higher risk of stomach upsets and stomach bleeds.</p> <p>Alcohol can increase the break-down of certain medicines, such as <a href="https://www.sciencedirect.com/science/article/abs/pii/S0149763421005121?via%3Dihub">opioids, cannabis, seizures, and even ritalin</a>. This can make the medicine less effective. Alcohol can also alter the pathway of how a medicine is broken down, potentially creating toxic chemicals that can cause serious liver complications. This is a particular problem with <a href="https://australianprescriber.tg.org.au/articles/alcohol-and-paracetamol.html">paracetamol</a>.</p> <p>At its worst, the consequences of mixing alcohol and medicines can be fatal. Combining a medicine that acts on the brain with alcohol may make driving a car or operating heavy machinery difficult and lead to a serious accident.</p> <h2>Who is at most risk?</h2> <p>The effects of mixing alcohol and medicine are not the same for everyone. Those most at risk of an interaction are older people, women and people with a smaller body size.</p> <p>Older people do not break down medicines as quickly as younger people, and are often on <a href="https://www.safetyandquality.gov.au/our-work/healthcare-variation/fourth-atlas-2021/medicines-use-older-people/61-polypharmacy-75-years-and-over#:%7E:text=is%20this%20important%3F-,Polypharmacy%20is%20when%20people%20are%20using%20five%20or%20more%20medicines,take%20five%20or%20more%20medicines.">more than one medication</a>.</p> <p>Older people also are more sensitive to the effects of medications acting on the brain and will experience more side-effects, such as dizziness and falls.</p> <p>Women and people with smaller body size tend to have a higher blood alcohol concentration when they consume the same amount of alcohol as someone larger. This is because there is less water in their bodies that can mix with the alcohol.</p> <h2>What drugs can’t you mix with alcohol?</h2> <p>You’ll know if you can’t take alcohol because there will be a prominent warning on the box. Your pharmacist should also counsel you on your medicine when you pick up your script.</p> <p>The most common <a href="https://adf.org.au/insights/prescription-meds-alcohol/">alcohol-interacting prescription medicines</a> are benzodiazepines (for anxiety, insomnia, or seizures), opioids for pain, antidepressants, antipsychotics, and some antibiotics, like metronidazole and tinidazole.</p> <p>It’s not just prescription medicines that shouldn’t be mixed with alcohol. Some over-the-counter medicines that you shouldn’t combine with alcohol include medicines for sleeping, travel sickness, cold and flu, allergy, and pain.</p> <p>Next time you pick up a medicine from your pharmacist or buy one from the local supermarket, check the packaging and ask for advice about whether you can consume alcohol while taking it.</p> <p>If you do want to drink alcohol while being on medication, discuss it with your doctor or pharmacist first.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/223293/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/nial-wheate-96839"><em>Nial Wheate</em></a><em>, Associate Professor of the School of Pharmacy, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/jasmine-lee-1507733">Jasmine Lee</a>, Pharmacist and PhD Candidate, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/kellie-charles-1309061">Kellie Charles</a>, Associate Professor in Pharmacology, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/tina-hinton-329706">Tina Hinton</a>, Associate Professor of Pharmacology, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-its-a-bad-idea-to-mix-alcohol-with-some-medications-223293">original article</a>.</em></p>

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Madonna rushed to intensive care

<p dir="ltr">Madonna was rushed to a hospital in New York and admitted into the ICU on Saturday after being found unresponsive. She has since been treated for a serious bacterial infection.</p> <p dir="ltr">The <em>Material Girl </em>was intubated for at least one night but is now reportedly out of the ICU, alert and recovering, according to Page Six.</p> <p dir="ltr">The singer had her daughter, Lourdes Leon, by her side during the entire ordeal.</p> <p dir="ltr">Madonna’s longtime manager, Guy Oseary, has released a statement on Instagram regarding the incident.</p> <p dir="ltr">“On Saturday June 24, Madonna developed a serious bacterial infection which led to a several day stay in the ICU,” he started the post.</p> <p dir="ltr">“Her health is improving, however she is still under medical care. A full recovery is expected,” he added.</p> <p dir="ltr">Oseary also announced that all of the singer’s current commitments including her upcoming world tour have been “paused” due to the medical emergency, however further details will be provided with new dates for the tour “as soon as we have them”.</p> <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-captioned="" data-instgrm-permalink="https://www.instagram.com/p/CuC6w1TPH_l/?utm_source=ig_embed&amp;utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/p/CuC6w1TPH_l/?utm_source=ig_embed&amp;utm_campaign=loading" target="_blank" rel="noopener">A post shared by Guy Oseary (@guyoseary)</a></p> </div> </blockquote> <p dir="ltr">The “Celebration” tour highlighting her greatest hits and the 40th anniversary of her breakout single, <em>Holiday</em> was set to kick off on July 15 in Vancouver and wrapped up in Amsterdam on December 1.</p> <p dir="ltr">Fans and celebrities alike have sent their love and report for the recovering star in the comment section of Oseary’s post.</p> <p dir="ltr">“Hope she feels better very soon!” commented <em>New Girl</em> actor Zoey Deschanel.</p> <p dir="ltr">“Sending her so much love from us. ❤️❤️❤️” wrote Aussie actress Isla Fisher.</p> <p dir="ltr">“Omg sending her love and healing light! 🙏” commented Ariana Grande’s brother Frankie.</p> <p dir="ltr">“Please send her my love and support. I’ll be sending prayers for her healing ❤️❤️🙏🙏,” wrote one fan.</p> <p dir="ltr">“Health is everything. Take as much time as needed,” commented another.</p> <p dir="ltr"><em>Images: Getty</em></p>

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"A night in hospital and a trip to the burns unit later”: Concerned mum's warning against popular fruit

<p><em><strong>Warning: This article contains images that some readers may find distressing.</strong></em></p> <p>An Aussie mum has taken to the internet and shared photos of her son’s severe burns that came as a result of him playing with a popular fruit. “A night in hospital and a trip to the burns unit later.” She began in her Facebook post.</p> <p>Her son Otis was playing happily outside with a lime in the sunshine, but the next day horror ensued.</p> <p>“It wasn’t until the next day that we noticed a rash appeared.” The mother said.</p> <p>The parents had assumed the rash must’ve been an allergic reaction to the lime juice, however, the rash quickly developed into a “horrific burn,” she added.</p> <p>The parents took Otis to the hospital where they were informed their son was suffering from a condition called phytophotodermatitis.</p> <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-permalink="https://www.instagram.com/p/Cku5QH2thxE/?utm_source=ig_embed&utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/p/Cku5QH2thxE/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by Tiny Hearts (@tinyheartseducation)</a></p> </div> </blockquote> <p>Phytophotodermatitis, more commonly known as margarita burn, is a little-known condition which causes burns to the skin when a chemical called furocoumarin reacts to sunlight.</p> <p>The chemical is found in limes, citrus fruit and some plants.</p> <p>“The small lime he had been innocently playing with - had now burnt his skin horrifically!“ The mum said. “If our story can help raise awareness into phytophotodermatitis at least something good has come out of our horrific experience!”</p> <p>The woman has urged parents to be on the lookout for this little-known skin condition.</p> <p>To minimise the risks of phytophotodermatitis, <a href="https://www.healthline.com/" target="_blank" rel="noopener">Healthline</a> suggests washing hands and other exposed parts of the skin immediately after being outdoors, wearing gloves when gardening, putting on sunscreen before going outdoors and wearing long-sleeved tops and pants in wooded areas.</p> <p>Photo credit: Getty</p>

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People with long COVID continue to experience medical gaslighting more than 3 years into the pandemic

<p><em><a href="https://theconversation.com/profiles/simran-purewal-1405366">Simran Purewal</a>, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a>; <a href="https://theconversation.com/profiles/kaylee-byers-766226">Kaylee Byers</a>, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a>; <a href="https://theconversation.com/profiles/kayli-jamieson-1431392">Kayli Jamieson</a>, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a>, and <a href="https://theconversation.com/profiles/neda-zolfaghari-1431577">Neda Zolfaghari</a>, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a></em></p> <p>It’s increasingly clear that the <a href="https://www.worldometers.info/coronavirus/country/canada/">SARS-CoV-2 virus is not going away</a> any time soon. And for some patients, their symptoms haven’t gone away either.</p> <p>In January 2023, our team of researchers at the <a href="https://pipps.ca/">Pacific Institute on Pathogens, Pandemics and Society</a> published a <a href="https://pipps.cdn.prismic.io/pipps/bd160219-3281-4c5d-b8be-57c301e7f99b_Long+Covid+Brief+Feb+2023.pdf">research brief</a> about how people seek out information about long COVID. The brief was based on a scoping review, a type of study that assesses and summarizes available research. Our interdisciplinary team aims to understand the experiences of people with long COVID in order to identify opportunities to support health care and access to information.</p> <h2>Lingering long COVID</h2> <p>Long COVID (also called <a href="https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/symptoms/post-covid-19-condition.html">Post COVID-19 condition</a>) is an illness that occurs after infection with COVID-19, lasting weeks to months, and even years. First coined by a <a href="https://doi.org/10.1016%2Fj.socscimed.2020.113426">patient on Twitter</a>, the term also represents a collective movement of people experiencing the long-term effects of COVID-19 and advocating for care. <a href="https://science.gc.ca/site/science/sites/default/files/attachments/2023/Post-Covid-Condition_Report-2022.pdf">Around 15 per cent</a> of adults who have had COVID still have symptoms after three months or more.</p> <p>Long COVID affects systems <a href="https://doi.org/10.1016/j.socscimed.2021.114619">throughout the body</a>. However, symptom fluctuations and limited diagnostic tools make it challenging for health-care providers to diagnose, especially with <a href="https://doi.org/10.1038/s41579-022-00846-2">over 200 symptoms</a> that may present in patients. Perhaps because long COVID presents itself in many different ways, the illness has <a href="https://doi.org/10.1016/j.socscimed.2021.114619">been contested</a> across the medical field.</p> <p>To identify opportunities to reduce barriers to long COVID care, our team has explored how patients and their caregivers access <a href="https://pipps.cdn.prismic.io/pipps/bd160219-3281-4c5d-b8be-57c301e7f99b_Long+Covid+Brief+Feb+2023.pdf">information about long COVID</a>. We have found that one of the most significant barriers faced by patients is <a href="https://doi.org/10.1177/20552076211059649">medical gaslighting</a> by the people they have turned to for help.</p> <h2>Lack of validation leads to stigma</h2> <p><a href="https://doi.org/10.1136/bmj.o1974">Medical gaslighting</a> occurs when health-care practitioners dismiss or falsely blame patients for their symptoms. While new information about long COVID has become more readily available, some patients continue to face gaslighting and feel that their symptoms are <a href="https://doi.org/10.1016%2Fj.ssmqr.2022.100177">treated less seriously</a> by some health-care professionals.</p> <p>This dismissal can <a href="https://doi.org/10.1111/hex.13602">erode trust</a> in the health-care system and can also lead to <a href="https://doi.org/10.1111/hex.13518">stigma and shame</a>.</p> <p>Preliminary findings from our ongoing study with long COVID patients indicate that, when medical practitioners do not validate a patient’s condition, this extends into community networks of family and friends who may also dismiss their symptoms, contributing to further stigmatization at home.</p> <p>Medical gaslighting can present additional barriers to treatment, such as not being referred to specialists or long COVID clinics. This can, in turn, compound other symptoms such as fatigue, and <a href="https://doi.org/10.1192/bjo.2022.38">exacerbate the psychological symptoms of long COVID</a>, such as depression and anxiety.</p> <p>Medical gaslighting isn’t new. It has been documented by patients with other chronic conditions, such as <a href="https://doi.org/10.5772/intechopen.107936">myalgic encephalomyelitis or chronic fatigue syndrome</a>. And while this is common for patients with <a href="https://doi.org/10.1001/amajethics.2021.512">non-visible illnesses</a>, medical gaslighting is more commonly experienced by <a href="https://doi.org/10.1111/1467-9566.13367">women and racialized people</a>.</p> <p>Long COVID patients also note gender biases, as women with prolonged symptoms feel they are not believed. This is particularly worrisome, as studies have found that <a href="https://doi.org/10.1001/jama.2020.17709">women are disproportionately more likely to experience long COVID</a>.</p> <h2>Where do we go from here?</h2> <p>While long COVID information is constantly shifting, it’s clear that patients face many barriers, the first of which is having their illness minimized or disregarded by others. To ensure that patients have access to compassionate care, we suggest:</p> <p><strong>1. Educating physicians on long COVID</strong></p> <p>Because definitions of long COVID, and its presentation, vary widely, primary care physicians need support to recognize and acknowledge the condition. General practitioners (GPs) must also provide patients with information to help manage their symptoms. This requires actively listening to patients, documenting symptoms and <a href="https://doi.org/10.1136/bmj.m3489">paying close attention to symptoms that need further attention</a>.</p> <p>Training physicians on the full range of symptoms and referring patients to available supports would reduce stigma and assist physicians by reducing their need to gather information themselves.</p> <p><strong>2. Raise awareness about long COVID</strong></p> <p>To increase awareness of long COVID and reduce stigma, public health and community-based organizations must work collaboratively. This may include a public awareness and information campaign about long COVID symptoms, and making support available. Doing so has the potential to foster community support for patients and improve the mental health of patients and their caregivers.</p> <p><strong>3. Ensure information is accessible</strong></p> <p>In many health systems, GPs are <a href="https://doi.org/10.1186/s12913-019-4419-0">gatekeepers to specialists</a> and are considered trusted information sources. However, without established diagnostic guidelines, patients are left to <a href="https://doi.org/10.2196/37984">self-advocate</a> and prove their condition exists.</p> <p>Because of negative encounters with health-care professionals, patients turn to social media platforms, including long COVID <a href="https://doi.org/10.7861%2Fclinmed.2020-0962">online communities</a> on Facebook. While these platforms allow patients to validate experiences and discuss management strategies, patients should not rely only on social media given the <a href="https://doi.org/10.3389/fpubh.2022.937100">potential for misinformation</a>. As a result, it is crucial to ensure information about long COVID is multi-lingual and available in a wide range of formats such as videos, online media and physical printouts.</p> <p>The <a href="https://science.gc.ca/site/science/en/office-chief-science-advisor/initiatives-covid-19/post-covid-19-condition-canada-what-we-know-what-we-dont-know-and-framework-action">recent recommendations of the Chief Science Advisor of Canada</a> to establish diagnostic criteria, care pathways and a research framework for long COVID are a positive development, but we know patients need support now. Improving long COVID education and awareness won’t resolve all of the issues faced by patients, but they’re foundational to compassionate and evidence-based care.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/203744/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/simran-purewal-1405366">Simran Purewal</a>, Research Associate, Health Sciences, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a>; <a href="https://theconversation.com/profiles/kaylee-byers-766226">Kaylee Byers</a>, Regional Deputy Director, BC Node of the Canadian Wildlife Health Cooperative; Senior Scientist, Pacific Institute on Pathogens, Pandemics and Society, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a>; <a href="https://theconversation.com/profiles/kayli-jamieson-1431392">Kayli Jamieson</a>, Master's Student in Communication, Research Assistant for Pacific Institute on Pathogens, Pandemics and Society, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a>, and <a href="https://theconversation.com/profiles/neda-zolfaghari-1431577">Neda Zolfaghari</a>, Project Coordinator, Pacific Institute on Pathogens, Pandemics and Society, and the Pandemics &amp; Borders Project, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/people-with-long-covid-continue-to-experience-medical-gaslighting-more-than-3-years-into-the-pandemic-203744">original article</a>.</em></p>

Caring

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9 medical reasons your short-term memory is getting worse

<p><strong>What is short-term memory?</strong></p> <p>Short-term memory is the type of memory you need to accomplish your immediate goals, explains Dr Patrick Lyden, chair of the department of neurology at Cedars-Sinai Hospital. That may be working your way through tasks during the workday, remembering someone’s name, email, or phone number, or recalling where you tossed your keys when you got home.</p> <p><strong>Where is it located in the brain?</strong></p> <p>When someone rattles off their phone number, you file it away in brain circuits that include the hippocampus (your memory centre) and the amygdala (your emotional hub). Depending on how important the short-term memory item may be (your address, someone you call all the time), it can be converted into long-term memory, says Dr Lyden.</p> <p><strong>How does short-term memory work?</strong></p> <p>Short-term memory isn’t just about being able to quickly recall new info; there are three phases. “You have to register the information, store the information, and retrieve the information,” says Dr Lyden. Registering means that you’re paying attention in the first place. Storing the info means you’ve filed it away in your brain. Retrieval is the ability to access the memory again. Any of these steps can break down, he says.</p> <p><strong>Is your memory okay?</strong></p> <p>Many people assume they have a memory problem when the explanation is something else entirely, says Dr Lyden. Maybe you’re not paying attention because you’re gazing at your phone or texting, for example. The first step to figuring out if something is going on is to “pay closer attention,” he says. Repeat the new information three times to commit it to memory.</p> <p><strong>When it may be time to worry</strong></p> <p>If you can’t pass the “pay attention test” despite repeating the information, your next step, advises Dr Lyden, is to determine if your problem is storing new memories or retrieving them. If you’re having a problem remembering a new acquaintance’s name, ask them to give you three choices – like Carrie, Lauren, or Janet. If your problem is storing new memories, you won’t be able to remember. But if your problem is retrieval, you’ll remember that her name is Janet once you hear the correct name.</p> <p>Having trouble with retrieving a short-term memory isn’t as serious as being unable to store them. “The storage problem is a serious problem, and you should see a neurologist,” he says.</p> <p><strong>Inactivity</strong></p> <p>Blood flow is good for your brain – it keeps it young. “Exercising boosts blood flow to your brain. If you stay active, you’ll have a better memory,” says Dr Daniel G. Amen, author of <em>Memory Rescue: Supercharge Your Brain, Reverse Memory Loss, and Remember What Matters Most</em>. Dr Lyden suggests daily exercise and it doesn’t have to be intense. “A one-kilometre run daily is better than a 10-kilometre run one day a week,” he says.</p> <p><strong>Substance abuse</strong></p> <p>According to Dr Amen, marijuana a toxin that impairs memory. “Marijuana lowers every area of the brain and ages it. On average, pot smokers have brains three years older than non-smokers,” he says. Alcohol abuse can also harm your memory.</p> <p><strong>Mental health conditions</strong></p> <p>People tend to miss their own depression. But if you’re suffering from depression, anxiety, or chronic stress, get help or your memory can also pay the price. “These conditions may all hurt the brain,” says Dr Amen. Getting relief will not only improve your life and outlook but save your brain.</p> <p><strong>Lack of sleep</strong></p> <p>When considering short-term memory loss causes, poor sleep is a big one. “If you don’t sleep seven hours a night or more, you’ll be in trouble. Your brain cleans itself at night. When you don’t get enough, it’s like the garbage collectors didn’t come to clean up,” says Dr Amen.</p> <p><strong>Dementia</strong></p> <p>Before you panic, there’s some good news: “The vast majority of people who are healthy will not have a degenerative neurological condition causing short-term memory loss,” says Dr Lyden. But dementia or Alzheimer’s is a possibility in some groups. If you’re over 60 and have risk factors like diabetes, high blood pressure, or obesity, then you may be more prone to problems and need to be evaluated, he says.</p> <p><strong>Medication</strong></p> <p>If you lead a healthy lifestyle, eat right, exercise, and go easy on alcohol and other substances that can harm memory, yet you still feel like your memory if failing, talk to your doctor about your medications – prescription and over-the-counter, advises Dr Lyden. Cholesterol drugs, painkillers, high blood pressure pills, and sleeping pills are among the drugs that can trigger memory issues.</p> <p><strong>Hypothyroidism</strong></p> <p>When you have an under-active thyroid, everything in your body runs slower. Your digestion will slow and you can become constipated; cell growth slows and can lead to hair loss; your metabolism becomes sluggish, triggering weight gain. And you may be plagued by muddied thinking or forgetfulness. Often, medication to restore thyroid hormones can help alleviate symptoms and help you feel better all over.</p> <p><strong>A poor diet</strong></p> <p>Inflammation is bad for your body and your brain. “The higher the inflammation levels in your body, the worse your memory will be,” says Dr Amen. Eating an anti-inflammatory diet, like the Mediterranean diet, and avoiding foods that increase it (highly processed foods, loads of sugar) is key. He also recommends taking fish oil and probiotics.</p> <p><strong>Lyme disease</strong></p> <p>Lyme disease is transmitted through a tick bite, and causes early symptoms like fever, chills, headache, and fatigue, according to the Centers for Disease Control and Prevention (CDC). Later on, without treatment, some people also may notice short-term memory problems. Dr Amen points out this may include trouble with attention, focus, and organisation. Keep in mind that the types of tick that carry the bacteria are not native to Australia and it’s not likely you can catch Lyme disease in Australia.</p> <p><strong>When to seek help</strong></p> <p>Along with the self-test mentioned earlier, think about how you perceive your short-term memory. Ask yourself: Is it getting progressively worse? Is it worse than 10 years ago? Are other people noticing a problem? “Those are things you should take seriously,” says Dr Amen.</p> <p><em>Image credits: Getty Images</em></p> <p><em>This article originally appeared on <a href="https://www.readersdigest.co.nz/healthsmart/9-medical-reasons-your-short-term-memory-is-getting-worse-2?pages=1" target="_blank" rel="noopener">Reader's Digest</a>. </em></p>

Mind

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Know the signs of a heart attack this Heart Week

<p dir="ltr">Research conducted by Heart Smart Australia, an online health and wellbeing program, has revealed the concerning reality that only one third of Australians (38% of the 1,031 people surveyed) are able to recognise the symptoms of a heart attack, despite cardiovascular disease being attributed to <a href="https://www.heartfoundation.org.au/bundles/for-professionals/key-stats-cardiovascular-disease">25% of deaths in the country</a>. </p> <p dir="ltr">And during <a href="https://campaign.heartfoundation.org.au/heart-week">Heart Week</a>, which runs from May 1 to May 7, the organisation hopes to both raise awareness and educate everyone on the warning signs, from the obvious to the lesser known, to hopefully reduce an individual’s risk of heart disease.</p> <p dir="ltr">As explained on the official website for the initiative, Heart Week is “Australia’s national heart health awareness week” and “provides an opportunity for the Australian public and health professionals to start a conversation about heart health and take positive steps to reduce their heart disease risk.” </p> <p dir="ltr">Surprisingly, the generation with the least existing awareness are the Baby Boomers, with research showing that only 33% of them are typically able to recall all of the signs and symptoms.</p> <p dir="ltr">Roughly 98% of Australians were able to call one or more of the most common symptoms to mind, while only 55% were aware that fatigue is one of such signs. Fewer still - approximately 48% - could name nausea and vomiting as another. </p> <p dir="ltr">The numbers are far lower than ideal, and as leading cardiologist and Chief Medical Officer of Heart Smart Australia Dr Ross Walker explained, “heart attack can be a silent killer; therefore, it’s crucial that Australians are aware of all the symptoms, including the lesser-known ones such as fatigue, chest discomfort and vomiting.</p> <p dir="ltr">“If you experience any of these symptoms, it's important to seek medical attention immediately. We know that acting quickly reduces damage to the heart and increases chances of survival - it really is this important. Life or death!"</p> <p dir="ltr">Cardiovascular disease (otherwise known as CVD) accounts for a staggering one hospitalisation every single minute in Australia, so this Heart Week, Dr Walker is calling on everyone to get on top of their health, to learn the symptoms, and to make the necessary changes towards reducing the impact and risk of CVD. </p> <p dir="ltr">“Heart Health Week is the perfect opportunity for Australians to take stock of their heart health and make positive changes to their lifestyle,” he explained. “For example, we know that implementing some simple changes can reduce the risk profile for developing CVD. </p> <p dir="ltr">“Looking at things like participating in regular exercise, maintaining a healthy weight, not smoking, getting adequate sleep and eating a healthy, balanced diet are key."</p> <p dir="ltr">Some of Dr Walker’s main tips include forming strong social networks, not overlooking the importance of a healthy diet, exercising regularly, attending regular heart health check ups with medical professionals, and knowing the symptoms. </p> <p dir="ltr">“It’s not widely known, nor understood, but those with strong ties to friends and family fare better when it comes to lowering risk of heart disease. Regularly spend some guilt free time with loved ones - it’s for your heart,” he said. </p> <p dir="ltr">And as for diet, “Variety is key here. As well as a range of fruit and vegetables, including things like Omega 3’s and turmeric can work to decrease inflammation, a key risk factor for CVD.”</p> <p dir="ltr">For exercise, Dr Walker recommends a minimum of “5 or more active days”, with no less than two-and-a-half hours each week dedicated to physical activity.</p> <p dir="ltr">Heart health check ups are crucial, according to Dr Walker, who suggests that anyone over the age of 45 (or 30 for Indigenous Australians) should contact their doctor for a check up. </p> <p dir="ltr">“This check will include things like measuring blood pressure, cholesterol levels and assessing weight,” he noted. “Identifying risk works to pre-empt issues and is often an important preventative measure.” </p> <p dir="ltr">And when it comes to the symptoms, Dr Walker believes it to be imperative to recognise them, so that you can act immediately and get help as soon as possible if someone you know may be suffering from one, “as early treatment is strongly linked to better health outcomes”.</p> <p dir="ltr">Those all-important symptoms include chest pains - pressure and tightness - as well as dizziness and light-headedness, nausea or vomiting, indigestion, sweat, an unusually pale complexion, difficulty breathing and shortness of breath, and palpitations. </p> <p dir="ltr">Additionally, when dealing with a suspected heart attack in females, it’s important to watch out for breathlessness and general unwellness, tightness and discomfort of the arms, chest pains that are reminiscent of burning and trapped wind, as well as upper back pain and pressure in the area. </p> <p dir="ltr">For more information, and to learn more about the education and support on offer, head over to Heart Smart Australia’s official website: <a href="https://heartsmartaustralia.com/">https://heartsmartaustralia.com/</a> </p> <p dir="ltr"><em>Images: Getty</em></p>

Body

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“Game-changer”: Michael J Fox shares huge medical news

<p dir="ltr">Michael J Fox has shared news of a medical breakthrough into Parkinson’s disease.</p> <p dir="ltr">The 61-year-old – who was diagnosed with the disease in 1991 – was thrilled to share the news, despite suffering a “terrible year”.</p> <p dir="ltr">Fox told <a href="https://www.statnews.com/2023/04/12/michael-j-fox-parkinsons-biomarker/" target="_blank" rel="noopener"><em>Stat News</em></a> that he had broken multiple bones after a fall, including some in his hand and face, but has said that in some ways he is “feeling better”.</p> <p dir="ltr">Despite his own personal battle, the <em>Back to the Future</em> star was overjoyed to share the breakthrough in Parkinson’s research.</p> <p dir="ltr">The study – funded by Fox’s charity organisation that aims to find a cure for Parkinson’s – found that a key Parkinson's pathology can now be identified by examining spinal fluid from living patients, allowing earlier intervention.</p> <p dir="ltr">“It’s all changed. It can be known and treated early on. It’s huge,” he said</p> <p dir="ltr">“This is the thing. This is the big reward. This is the big trophy.”</p> <p dir="ltr">The findings, published in <em>The Lancet Neurology</em>, are the result of a 1,123-person study that Fox’s foundation has put hundreds of millions of dollars into since it began in 2010.</p> <p dir="ltr">An editorial in the medical journal has also called this research “a game-changer in Parkinson’s disease diagnostics, research, and treatment trials”.</p> <p dir="ltr">In late 2022 the actor opened up about his struggle with Parkinson’s in his emotional acceptance speech for the <a href="https://www.oversixty.co.nz/health/caring/michael-j-fox-reveals-more-details-about-his-struggle-with-parkinson-s" target="_blank" rel="noopener">Jean Hershel Humanitarian Award</a>.</p> <p dir="ltr">In the speech he said that the hardest part “was grappling with the certainty of the diagnosis and the uncertainty of the situation,” but has since felt relieved after an “outpouring of support” from the public and his peers.</p> <p><em>Image: Frazer Harrison for Getty Images</em></p>

Caring

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Mum of four saved by her smartwatch

<p dir="ltr">Ricki-Lee Wynne was gifted a smartwatch from her husband for her 40th birthday and she believes that without it, she wouldn’t be alive today.</p> <p dir="ltr">"There's no doubt that my smartwatch saved my life," she told 9news.com.au.</p> <p dir="ltr">Months prior to receiving the watch, Wynne had been experiencing strange health problems. </p> <p dir="ltr">"I was getting a pain over my shoulder blades and it hurt each time I breathed in," she said.</p> <p dir="ltr">Doctors were confused and Wynne was in and out of hospital having several X-rays, scans and blood tests in an attempt to find the underlying issue.</p> <p dir="ltr">Wynne also had an echocardiogram to test the functioning of her heart, all of which appeared normal. </p> <p dir="ltr">"The doctors were not sure what it was. They thought it could be a low-grade blood cancer," she said. </p> <p dir="ltr">The pain subsided for a little while but soon enough Wynne’s breathing problems returned. </p> <p dir="ltr">"I woke up one day and I couldn't breathe properly. I was just walking into work and I was thinking, 'Gosh, I can't get enough air into my lungs,'" she said.</p> <p dir="ltr">"I couldn't walk from one side of the room to the other without being short of breath.</p> <p dir="ltr">"I went to my GP and had an x-ray done, but nothing showed up.”</p> <p dir="ltr">That’s when Wynne noticed her smartwatch was acting up. </p> <p dir="ltr">"I'd been struggling with my watch for days to try and get the heart rate to show up," she said. </p> <p dir="ltr">The heart rate function of her smartwatch had never been an issue before, but now it was struggling to pick it up. </p> <p dir="ltr">"It was saying you need to change the position to measure a pulse," she said.</p> <p dir="ltr">"My chest was also feeling kind of wobbly for a couple of nights when I went to bed.”</p> <p dir="ltr">Despite her X-ray showing coming up clear, Wynne said she went back to see her GP and told him she was worried something was really wrong.</p> <p dir="ltr">"I just said to him, 'Even my heart rate isn't right, look at my watch,' and I showed it to him.”</p> <p dir="ltr">Wynne’s GP sent her off for an ECG which showed her heart rate had dropped to just 29 beats per minute, a major cause for concern. </p> <p dir="ltr">"As soon as I had the ECG, I had the doctor call me back and say you need to go straight to Box Hill Hospital," she said.</p> <p dir="ltr">"I was told at the hospital that if I hadn't come in I would have just died in my sleep.</p> <p dir="ltr">"I would not have woken up and my heart would have stopped.”</p> <p dir="ltr">Wynne was then fitted with an emergency pacemaker and eventually diagnosed with a rare auto-immune disorder called sarcoidosis, a condition that causes inflammation in different parts of the body, most commonly the lungs. </p> <p dir="ltr">Doctors believe Wynne's sarcoidosis moved from her lungs to her heart, causing her to become extremely ill. </p> <p dir="ltr">She still has the pacemaker in and combined with medication, her health has improved significantly. </p> <p dir="ltr">It’s safe to say Wynne won’t be taking off her smartwatch any time soon.</p> <p dir="ltr"><em>Image credit: Shutterstock</em></p>

Technology

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F1 legend shares rare update Michael Schumacher

<p>Formula 1 icon Eddie Jordan has shared a health update about his close friend Michael Schumacher, saying the motorsport legend is “there, but not there” as mystery continues to surround his health.</p> <p>Schumacher, 54, has not been seen or heard from for nearly ten years after his horror ski crash in 2013.</p> <p>He was left with a severe brain injury and in a medically induced coma.</p> <p>Mystery surrounds his condition as his family has imposed a strict “family only” rule on who can visit him.</p> <p>It came as Michael’s son Mick followed in his dad’s footsteps into F1.</p> <p>Unfortunately, 23-year-old Mick struggled and lost his race seat at the end of 2022 after a series of crashes for the Haas team.</p> <p>Eddie was denied a visit to see Michael but has been in contact with Mick.</p> <p>The F1 star said his “love” for the seven-time world champion “still lasts and will always do so while I’m able to draw breath.” when speaking to sports betting firm OLBG.</p> <p>Last year, he revealed his son Mick had reached out to him.</p> <p>“As far as I’m concerned, I was touched by it and the reason I was touched by it was because it can’t be easy knowing that your father is not able to be part of the family, he’s there but he’s not there,” Jordan said.</p> <p>Jordan revealed that Mick spoke highly of his father while he was enduring his own struggles in F1.</p> <p>“It touched me because I felt so much about Michael, I went out of my way to find him, give him his first chance in Spa, didn’t last very long but that love for him still lasts and will always do so while I’m able to draw breaths,” Eddie said.</p> <p>Mick was dropped by Haas in favour of veteran driver Nico Hulkenberg for 2023 and is now a reserve driver at Mercedes.</p> <p>Mick will be backing up Sir Lewis Hamilton and George Russell, potentially stepping in for them if they have to miss a race.</p> <p>Eddie believes Mick has it in him to find his way back into a full-time race seat.</p> <p>“He’s been dropped for somebody else, and that’s a tough decision, he has another fight to come back and to make his name, climb up that ladder again,” Eddie said.</p> <p>“I’m quite sure he will do it.”</p> <p>Jordan also revealed Michael named his son after racing champion Mick Doohan, saying Mick was given his name “as a mark of respect” to Doohan.</p> <p>“Mick Schumacher isn’t named after his dad like a lot of people seem to think,” he said.</p> <p>“Mick Schumacher is named after a person who his father, Michael, was in total awe of, a sportsman who had won five world titles back to back with Honda.</p> <p>“And that is no other than Mick Doohan.</p> <p>“As a mark of respect, Michael Schumacher called his son Mick.”</p> <p>Last year, Jordan revealed that Michael’s wife denied him permission to visit Schumacher after his horror skiing accident.</p> <p>His wife Corinna keeps his health journey a closely guarded secret.</p> <p>Corinna prefers to treat her husband privately at their home in Geneva, Switzerland, with ex-Ferrarri boss Jean Todt, one of the only people allowed to see him outside his immediate family.</p> <p>Jordan said he contacted Corinna, who was once the girlfriend of his team’s driver Heinz Harold Frentzen.</p> <p>Jordan told the Irish Daily Mirror, “I reached out and one stage asked was it appropriate and did I think we should go and visit him.</p> <p>“The answer was no. No visitations for anyone at that moment except the actual direct family.</p> <p>“However, since then, young Mick Schumacher – Michael’s son – has reached out to me, and he has been extraordinary.”</p> <p><em>Image credit: Getty</em></p>

Caring

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Researchers puzzled by results of anti-inflammatory medications for osteoarthritis

<p>Researchers in the US are calling for a re-evaluation of the way some well known painkillers are prescribed after research showed they may actually lead to a worsening of inflammation over time in osteoarthritis-affected knee joints.</p> <p>NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) such as ibuprofen and naproxen are designed to reduce inflammation for the estimated 2.2 million Australians suffering from the sometimes debilitating effects of osteoarthritis.</p> <p>Osteoarthritis is a degenerative condition affecting joints in the body – most commonly hips, knees, ankles, spine and hands – which results from the degradation of cartilage on the ends of bones within the joints. As the cartilage wears away, the bones rub together resulting in swelling, pain and restricted movement.</p> <p>To combat this pain and swelling, NSAIDs are commonly prescribed, however the long-term impact of this type of medication is unclear, including its effect on the progression of the condition.</p> <p>“To date, no curative therapy has been approved to cure or reduce the progression of knee osteoarthritis,” said the study’s lead author, Johanna Luitjens, from the Department of Radiology and Biomedical Imaging at the University of California, San Francisco. “NSAIDs are frequently used to treat pain, but it is still an open discussion of how NSAID use influences outcomes for osteoarthritis patients.</p> <p>Surprisingly the report says: “…the impact of NSAIDs on synovitis, or the inflammation of the membrane lining the joint, has never been analysed using MRI-based structural biomarkers.”</p> <p>The study compared 793 participants with moderate to severe osteoarthritis of the knee who did not use NSAIDs, with 277 patients who received sustained treatment with NSAIDs for more than a year. Each patient underwent Magnetic Resonance Imaging (MRI) scans of the joint, which were then repeated after four years.</p> <p>The researchers were able to assess the images for indications of inflammation and arthritis progression including cartilage thickness and composition.</p> <p>The data showed the group using NSAIDs, had worse joint inflammation and cartilage quality than those not using NSAIDs, at the time of the initial MRI scan. And the follow-up imaging showed the conditions had worsened for the NSAID group.</p> <p>“In this large group of participants, we were able to show that there were no protective mechanisms from NSAIDs in reducing inflammation or slowing down progression of osteoarthritis of the knee joint,” said Luitjens.</p> <p>According to Luitjens, the common practice of prescribing NSAIDs for osteoarthritis should be revisited as there doesn’t appear to be any evidence they have a positive impact on joint inflammation nor do they slow or prevent synovitis or degenerative changes in the joint.</p> <p>There is also a possibility that NSAIDs simply mask the pain. Despite adjusting the study’s model for individual levels of patient physical activity, “patients who have synovitis and are taking pain-relieving medications may be physically more active due to pain relief, which could potentially lead to worsening of synovitis,” said Luitjens.</p> <p>Luitjens hopes future studies will better characterise NSAIDs and their impact on osteoarthritic inflammation. With one in three people over the age of 75 in Australia suffering from osteoarthritis and an estimated one in 10 women and one in 16 men set to develop it in the future, unlocking treatment options for this crippling condition is an imperative.</p> <p><strong>This article originally appeared on <a href="https://cosmosmagazine.com/science/osteoarthritis-puzzled-antiinflammatory/" target="_blank" rel="noopener">cosmosmagazine.com</a> and was written by Clare Kenyon.</strong></p> <p><em>Image: Shutterstock</em></p>

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Olivia Newton-John's selfless final wish

<p>Olivia Newton-John's final wishes have been revealed by her husband, as the star continued to lobby for fair and equal medical treatment until her final days. </p> <p>Olivia's husband, John Easterling, shared that Olivia wanted other patients to have the same access to alternative treatments that she felt "privileged" to be able to use. </p> <p>Speaking with the Herald Sun, John said, "Her dream with the Olivia Newton-John Wellness Centre was to have Australians going through cancer have access to the similar types of treatments."</p> <p>According to John, treatments such as medicinal cannabis "undoubtedly extended Olivia's life and gave her quality of life.</p> <p>For much of her life, Olivia lobbied for politicians to change regulations around medicinal cannabis to make it available to patients at Melbourne's ONJ Cancer Wellness and Research Centre.</p> <p>Olivia publicly advocated for alternative treatments even in her final hours and John noted his late wife didn't need "toxic chemicals or addictive painkillers" to manage her terminal illness.</p> <p>John also revealed to The Herald Sun that Olivia was "pain free" and "cheerful and joyful" in her final days.</p> <p>After her first breast cancer diagnosis in 1992, Olivia tried herbal formulas, meditation and "focused on a vision of complete wellness," which inspired Olivia to establish the institution after wanting to "help others going through the same journey".</p> <p>Olivia died after losing her decades-long battle with breast cancer in August. </p> <p><em>Image credits: Instagram </em></p>

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10 items you MUST carry in your travel medical kit

<p>Health concerns are the last thing you want to be dealing with when on holidays, but unfortunately accidents can still happen when we are travelling.</p> <p>This is why a travel medical kit is one of the most important things you will pack.</p> <p>From simple first aid measures to equipment that will help you in instances where something more serious is occurring, a well-stocked travel medical kit is the hallmark of every sensible traveller. Here are 10 items you must include in your travel medical kit.  </p> <p>We’ve also included some additional tips at the bottom of the article.</p> <p><strong>1. Adhesive dressings (Band-Aids)</strong> – When travelling we’re particularly susceptible to minor cuts. Adhesive dressings ensure these nicks and scrapes don’t get infected.</p> <p><strong>2. Antihistamine</strong> – These are essential, especially if you’re someone who suffers from allergies, as they allow you to control allergic reactions in foreign environments.</p> <p><strong>3. Bandages</strong> – Use bandages to create support structures for strained limbs, reduce swellings, hold dressings in place, and even as a makeshift sling.</p> <p><strong>4. Instant cold pack</strong> – These handy devices are especially useful when it comes time to deal with any swelling issues or untoward skin reactions encountered abroad.</p> <p><strong>5. Antibacterial gel</strong> – If you’re in a situation when you need a pair of clean hands, antibacterial gel makes it possible without the need of water access.</p> <p><strong>6. Oral rehydration salts</strong> – Dehydration can quickly turn into a big issues overseas, so having a few oral rehydration salts on hand can get you out of a serious bind. </p> <p><strong>7. Safety pins</strong> – The practicality of safety pins knows no bounds, especially if you find yourself in a situation where you need to keep bandages or slings in place.</p> <p><strong>8. Thermal blanket</strong> – In an emergency situation a thermal blanket can help control body temperature and ultimately avoid the likelihood of someone going into shock.</p> <p><strong>9. Thermometer</strong> – It’s also quite useful to have a thermometer at hand just in case. Go for a digital design that’s easier to read in an emergency situation.</p> <p><strong>10. Tweezers</strong> – If you ever need to remove splinters when you’re overseas or do running repairs to adhesive dressings, a pair of tweezers becomes quite useful.</p> <p><strong>Additional tips and pointers:</strong></p> <ul> <li>Keep you travel medical kit in a dry, cool storage location if possible.</li> <li>Make sure it’s in an easily accessible part of your suitcase or backpack, and make sure everyone you are travelling with knows where to find it.</li> <li>Before you head off, double check the contents of your kit ensuring any creams are up to date, bandages and dressings are properly sealed and all items are working properly.</li> </ul> <p><em>Image: Getty</em></p>

Domestic Travel

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Readers Respond: What is the most unprofessional thing a doctor has said to you?

<p dir="ltr">When you go to your family doctor or specialist the last thing you’d expect is something unprofessional being said. </p> <p dir="ltr">But unfortunately, it appears to be more common than we think and it is unacceptable. </p> <p dir="ltr">We asked our readers to shed some light on some of the unprofessional comments they’ve received from doctors and they are nothing but shocking.</p> <p dir="ltr">Check them out below.</p> <p dir="ltr">Julie Lancashire - At 90 years my mum got her pacemaker replaced after 10 years and the doctor saying he didn't expect he'd be doing it again. She's now 93 and counting!</p> <p dir="ltr">Carole Meyer - I was patted on the head and told I didn’t need to know how many stitches I had after giving birth.</p> <p dir="ltr">Rosalea Mifsud - I asked our doctor of 35 years if my husband could have Legionnaires' disease as he was extremely ill after opening the potting mix. Instead of swabbing or testing urine, his reply was “I don’t know as I have never had a patient with it”. My husband was ill for 2 months, but never diagnosed. He had a blood test which showed he had a virus.</p> <p dir="ltr">Jean Ahmet - My husband had a large operation to remove cancer. When he went for a check up a year later the registrar said to him “see you next year if you are still around”.</p> <p dir="ltr">Terrie Giancola - My husband was told he was considered “not viable” for surgery for liver cancer by a surgeon at a large public hospital in Melbourne, “go home enjoy what time you have left you won’t feel any pain”. Twenty-two years later after successful surgery at a large private hospital we both still remember the callousness of that comment.</p> <p dir="ltr">Margaret Gauld - Asking me what I was thinking about during an internal examination.</p> <p dir="ltr">Elizabeth Mcdowell - Went through years of pain and one day called into the hospital. The doctor checking me said l was faking the pain and wasting his time. Two more years of excruciating pain I saw a specialist who took my gallbladder out. He said it was full of puss and was very infected. Been fine ever since. </p> <p dir="ltr">Liz Wood - I was told to get pregnant and that would fix all my problems. Only thing was I had been told two weeks before having an operation for a burst cyst on my ovaries. I was then told I would not be able to have children. I reported the doctor for his insensitive comments. He had not read my case history.</p> <p dir="ltr">Vicki Pritchard - If you weren’t so overweight it wouldn’t have hurt as much! I fell down the cement stairs. I was in PAIN.</p> <p dir="ltr">Sue Schultz - Your baby shouldn't have died…but you are not the only one that has lost a baby!!!! I was just shattered.</p> <p dir="ltr">Share any unprofessional comments you’ve received <a href="https://www.facebook.com/oversixtyNZ/posts/pfbid02XYbmr2cQdZKdHTMxgHBTbKEMq7HCpVMoKGn2RMPSNjdJ5Ph6LDQGwRtbWQ5EtGV3l" target="_blank" rel="noopener">here</a>.</p> <p dir="ltr"><em>Image: Shutterstock</em></p>

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PINK sky at night?! Odd reason for unearthly glow over Aussie town

<p dir="ltr">Residents in the northern Victorian town of Mildura experienced an intriguing Wednesday night when the night sky was lit up with an eerie pink glow.</p> <p dir="ltr">“It was very bizarre,” said Tammy Szumowski.</p> <p dir="ltr">“I was on the phone to my mum, and my dad was saying the world was ending.”</p> <p><span id="docs-internal-guid-3af440d1-7fff-a4a9-13e4-3950847d9ceb"></span></p> <p dir="ltr">Though it looked like aliens or a portal to another universe could be behind it, the explanation for the mysterious light is firmly within reality. Pharmaceutical company Cann Group confirmed that the lights originated from its local medicinal cannabis facility, which had left its blackout blinds open.</p> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en"><a href="https://twitter.com/hashtag/Mildura?src=hash&amp;ref_src=twsrc%5Etfw">#Mildura</a> and surrounds were treated to a spectacular sight tonight when a red light appeared in the sky.<br />Was it aliens?<br />An aurora?<br />No, it appears to have been the hydroponic lights from a medicinal cannabis farm reflecting off cloud which is somehow the most Mildura answer ever. <a href="https://t.co/Wfy63tRrng">pic.twitter.com/Wfy63tRrng</a></p> <p>— Sarah Tomlinson (@sarah_tomlinson) <a href="https://twitter.com/sarah_tomlinson/status/1549381096587964416?ref_src=twsrc%5Etfw">July 19, 2022</a></p></blockquote> <p dir="ltr">“Cannabis plants require different spectrums of light in order to encourage their growth,” said Rhys Cohen, senior communications manager at Cann Group Ltd.</p> <p dir="ltr">“A red spectrum light is often used. Normally the facility would have blackout blinds that come down at night, and will in the future block that glow.”</p> <p dir="ltr">Dr Anne Webster, the federal member for Mallee, was driving home in the dark when she noticed the pink light.</p> <p dir="ltr">“I thought that is weird. There is no city out there … What is it?” she said.</p> <p dir="ltr">“When I understood the Cann processing site is there – but it still was the first time I’ve seen that pink glow. It was quite strange.”</p> <p dir="ltr"><span id="docs-internal-guid-85425684-7fff-d79d-3524-30e809599a35"></span></p> <p dir="ltr">Photos of the lights quickly spread on social media, with ABC Chief of Staff Sarah Tomlinson describing the fact it came from a medical cannabis facility as “somehow the most Mildura answer ever”.</p> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en">Hey <a href="https://twitter.com/JaneBunn?ref_src=twsrc%5Etfw">@JaneBunn</a> any reports of this scary but brilliant sky over Mildura tonight ?? <a href="https://t.co/3WZ7FZj1zp">pic.twitter.com/3WZ7FZj1zp</a></p> <p>— Tim Green (@Tim_Green78) <a href="https://twitter.com/Tim_Green78/status/1549326548502970369?ref_src=twsrc%5Etfw">July 19, 2022</a></p></blockquote> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en">Mildura, Australia: Is it a plane.. an UFO... Superman? Turns out someone forgot to close the blinds at a Cannabis farm. <a href="https://t.co/HaokIwJn2c">pic.twitter.com/HaokIwJn2c</a></p> <p>— Jürgen "jkr" Kraus (@jkr_on_the_web) <a href="https://twitter.com/jkr_on_the_web/status/1550201444699017216?ref_src=twsrc%5Etfw">July 21, 2022</a></p></blockquote> <p dir="ltr">La Trobe University also joined in on the fun, tweeting: “We can neither confirm, nor deny, that the mysterious lights over Mildura were <em>Aurora marijuanis</em>.”</p> <p dir="ltr">The Mildura facility gathered its first commercial harvest of marijuana crops in June, after Cann Group - the first Australian company licensed to grow the crop for medicinal and research purposes - acquired the site in 2019.</p> <p dir="ltr">Dr Webster described it as “quite an exciting site”, though its exact location is a secret and isn’t open to the public due to the nature of its business.</p> <p dir="ltr">“Propagation of cannabis is really interesting and the way they use lights … to increase the growth cycle and speed up the whole process is quite amazing,” she said.</p> <p dir="ltr">“I look forward to many other innovative producers coming to the region and bringing their glows with them.”</p> <p dir="ltr"><span id="docs-internal-guid-2c7e2cfa-7fff-f9a3-9a9e-ee91cff6f50b"></span></p> <p dir="ltr"><em>Image: Twitter</em></p>

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Physio ‘dry needling’ and acupuncture – what’s the difference and what does the evidence say?

<p>Physiotherapists are increasingly offering needling therapies in addition to their standard care. Many Australian <a href="https://australian.physio/research/prf/translation/five-facts-about-acupuncture-and-dry-needling-musculoskeletal-pain" target="_blank" rel="noopener">physiotherapists</a> in private practice now offer dry needling or Western medical acupuncture as part of a treatment approach.</p> <p>Is it just a fad or does science support it?</p> <h2>Needling, three ways</h2> <p>Physiotherapists can be trained to use dry needling, Western acupuncture and/or traditional acupuncture.</p> <p><a href="https://pubmed.ncbi.nlm.nih.gov/23801002/" target="_blank" rel="noopener">Dry needling</a> involves penetrating the skin with needles to altered or dysfunctional tissue in order to improve or restore function. This often involves needling muscle trigger points to activate a reflexive relaxation of the muscle.</p> <p><a href="https://pubmed.ncbi.nlm.nih.gov/28739020/" target="_blank" rel="noopener">Western acupuncture</a> uses traditional needling <a href="https://www.sciencedirect.com/science/article/pii/S2005290110600143" target="_blank" rel="noopener">meridians</a> (the ancient idea of energy channels through the body) and trigger points. But these ideas are applied to Western understandings of anatomy. In Western acupuncture, points are stimulated to create local tissue changes, as well as spinal and brain effects. The goals is to trigger pain-relieving chemicals, muscle activation or relaxation.</p> <p>Even though traditional acupuncture points are used with this style of needling, Western acupuncture is not viewed as traditional Chinese medicine.</p> <p><a href="https://healthtimes.com.au/hub/pain-management/44/research/kk1/acupuncture-for-pain-management/1581/" target="_blank" rel="noopener">Traditional acupuncture</a> uses meridian lines or other points based on traditional Chinese medicine assessment methods and approaches.</p> <p>All physiotherapists trained in either acupuncture or dry needling meet safety standards which are viewed as within scope by the <a href="https://www.ahpra.gov.au/" target="_blank" rel="noopener">Australian Health Practitioners Regulatory Agency</a> and the <a href="https://www.physiotherapyboard.gov.au/" target="_blank" rel="noopener">Physiotherapy Registration Board</a>. These standards cover the level of training required, registration to practice and safety standards that include needle safety and hygiene to protect the public.</p> <p>Minor reported <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7015026/#:%7E:text=Examples%20of%20minor%20adverse%20reactions,pain%20during%20or%20after%20treatment." target="_blank" rel="noopener">side effects</a> related to acupuncture including pain and bleeding or bruising from needle insertion are fairly common. But major adverse events – pneumothorax (collapsed lung), excessive bleeding, prolonged aggravation – are rare.</p> <h2>What’s needling good for?</h2> <p>Research into the effectiveness of acupuncture and dry needling is variable. Some studies show comparable results between dry needling and acupuncture, while others show more favourable results for one or the other depending on the condition being treated.</p> <p>A <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD001351.pub2/full?highlightAbstract=dry%7Cdri%7Cneedl%7Cneedling" target="_blank" rel="noopener">review</a> that assessed the effects of acupuncture and dry needling for the treatment of low-back pain found they may be useful add-on therapies but could not make firm conclusions due to a lack of quality trials.</p> <p>Another <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6600071/#CIT0034" target="_blank" rel="noopener">review</a> reported the growing popularity of dry needling world wide and across disciplines and points out that many questions still remain regarding the use of needling.</p> <p>For <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD001218.pub3/full?highlightAbstract=acupuncture%7Cmigraine%7Cmigrain%7Cacupunctur" target="_blank" rel="noopener">migraine</a> and <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD007587.pub2/full?highlightAbstract=acupuncture%7Cheadach%7Ctension%7Cacupunctur%7Cheadache%7Ctype" target="_blank" rel="noopener">tension</a> headaches, experts say acupuncture seems to reduce the frequency and intensity of attacks – though more research is needed to compare it to other treatments.</p> <p>Acupuncture and dry needling may reduce pain and improve function for people with <a href="https://pubmed.ncbi.nlm.nih.gov/17224820/" target="_blank" rel="noopener">neck pain</a>. A systematic review found significant differences between acupuncture and “sham acupuncture” (which is performed away from acupuncture points) when used to treat <a href="https://pubmed.ncbi.nlm.nih.gov/22965186/" target="_blank" rel="noopener">certain types of chronic pain</a>. However, some research only shows <a href="https://pubmed.ncbi.nlm.nih.gov/33066556/" target="_blank" rel="noopener">small and temporary</a> relief for neck pain with dry needling.</p> <p>Results from randomised control trials support the use of needling for <a href="https://pubmed.ncbi.nlm.nih.gov/27062955" target="_blank" rel="noopener">shoulder pain</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/32301166/" target="_blank" rel="noopener">tennis elbow</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/32186030/" target="_blank" rel="noopener">osteo arthritic knee pain</a>. But a recent systemic review of research reported only weak evidence to support needling to treat <a href="https://pubmed.ncbi.nlm.nih.gov/33760098/" target="_blank" rel="noopener">plantarfasciitis and chronic ankle instability</a>.</p> <h2>Not just for sporting injuries</h2> <p>Similarly, small randomised control trials have shown acupuncture and dry needling might reduce <a href="https://pubmed.ncbi.nlm.nih.gov/17095133/" target="_blank" rel="noopener">problematic jaw pain</a> (<a href="https://www.hopkinsmedicine.org/health/conditions-and-diseases/temporomandibular-disorder-tmd#:%7E:text=Temporomandibular%20disorders%20(TMD)%20are%20disorders,may%20result%20in%20temporomandibular%20disorder." target="_blank" rel="noopener">temporo mandibular disorder</a>) and improve mouth opening.</p> <p>Systematic reviews have reported needling and acupuncture were safe and effective recommendations for the treatment of broad conditions of <a href="https://www.healthline.com/health/tendinopathy" target="_blank" rel="noopener">tendinopathy</a> (the breakdown of collagen in tendons) and <a href="https://pubmed.ncbi.nlm.nih.gov/30787631/#:%7E:text=At%20follow%2Dup%20in%20the,for%20the%20management%20of%20FM." target="_blank" rel="noopener">fibromyalgia</a> (chronic pain in the muscles and bones).</p> <p>For women’s health, acupuncture has been shown to be effective for reducing pain with <a href="https://pubmed.ncbi.nlm.nih.gov/29879061/" target="_blank" rel="noopener">periods</a>, compared to no treatment or non-steroidal pain relief medications – but the research had design limitations.</p> <p>Though <a href="https://www.cochrane.org/CD002962/PREG_acupuncture-or-acupressure-induction-labour#:%7E:text=Acupuncture%20involves%20the%20insertion%20of,with%20onset%20of%20labour%20contractions." target="_blank" rel="noopener">widely used</a> in pregnancy, research into the use of acupuncture to <a href="https://pubmed.ncbi.nlm.nih.gov/32032444/" target="_blank" rel="noopener">induce labour</a> reports it may increase satisfaction with pain management and reduce pain intensity. But it may have little to no effect on the rates of caesarean or assisted vaginal birth.</p> <p>In summary, it appears needling techniques – whether dry needling or acupuncture – generally show positive effects over no treatment or “sham” treatments, but more research and high quality trials are needed.</p> <h2>Just one part of a treatment program</h2> <p>Needling <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD001351.pub2/full?highlightAbstract=dry%7Cdri%7Cneedl%7Cneedlin" target="_blank" rel="noopener">may be useful</a> as part of multimodal care – that is, when <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4780149/" target="_blank" rel="noopener">more than one treatment</a> is used in conjunction to treat a problem.</p> <p>Physiotherapists may combine needling therapies with exercise prescription, hands-on care including massage, mobilisations and manipulations, and taping techniques. They may also employ therapies that apply external energy such as ultrasound, laser, transcutaneous (under the skin) electrical nerve stimulation and biofeedback.</p> <p>Finally, while the various needling techniques all use a filiform needle (with a solid filament as opposed to a hollow bore needle), the styles with each can be quite different. Ask what style of needling is being employed to treat you, and if you have a history of finding one style works better for you, discuss this with your practitioner.</p> <p><em><strong>This article originally appeared on <a href="https://theconversation.com/physio-dry-needling-and-acupuncture-whats-the-difference-and-what-does-the-evidence-say-181939" target="_blank" rel="noopener">The Conversation</a>.</strong></em></p> <p><em>Image: Shutterstock</em></p>

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