you know that every hour, a man, woman or child dies from heart disease and
stroke in Ireland? High blood pressure is a major reason for these premature
If you have been diagnosed or suspected of having high blood pressure,
it is important you get it monitored with a 24 hour blood pressure monitor.
Whelehans Pharmacy in Mullingar can now fit you with a 24 hour blood pressure
which you can now wear while undertaking normal daily activities. You can book
the service by calling 04493 34591.
Why get a 24 hour blood pressure check?
A 24 hour blood pressure monitor provides a more accurate measure of
blood pressure than a single measurement. It shows how your blood pressure
changes throughout the day and more importantly at night. It helps your doctor
and pharmacist ensure your blood pressure is under control. If you are already
taking blood pressure medication, our 24 blood pressure monitor will show if
you are getting the full benefit of the blood pressure medication you must
Blood pressure-the silent killer
According to latest statistics, high blood pressure causes 54% of stroke
and 47% of heart disease worldwide. High blood pressure is often called the
silent killer with many people not realising they have it until it is too late,
for example after they have suffered a stroke or heart attack.
do I measure my blood pressure accurately?
Research indicates that
the most accurate form of blood pressure measurement is to get it measured over
a 24 hour period. Because high blood pressure rarely has any symptoms, the only
way to tell you have this condition is to get your blood pressure measured
accurately. Health experts in the UK now advise not to commence on blood
pressure medication until you get a 24 hour blood pressure check.
A 24 hour blood pressure
monitor could save your life
Whelehans Pharmacy today to arrange getting your 24 hour blood pressure
checked, it could save your life. Whelehans 24 hour Blood Pressure service
costs €50. We simply fit the monitor in the morning, you wear it for 24 hours
and when you come back the next morning we will have your results.
Whelehans Pharmacy, 38
Pearse St, Mullingar (opposite the Greville Arms Hotel). Tel 04493 34591. Web. www.whelehans.ie
If you take painkillers for longer
than 15 days (3 days for codeine) you run the risk of getting
medication-overuse headaches. The headaches caused by painkiller overuse last
an average of four or more hours. What happens is that after taking a painkiller for
headaches for a prolonged period of time, your body becomes used to the
painkillers. A 'rebound' or 'withdrawal' headache then develops if you do not
take a painkiller within a day or so of the last dose. When the effect of each
dose has worn off, a further withdrawal headache develops, and so on. A vicious circle develops. This
phenomenon only seems to occur when taking painkillers for headaches; it does
not seem to occur when taking painkillers regularly for other conditions like
headache is the third most common cause of headache after migraine and
tension-type headache. About 1 in 50 people develops this problem at some time
in their life. It can occur at any age but is most common in people in their
30s and 40s. It is more common in women than men. The headache of
medication-overuse headache is often described as ' overwhelming' and tends to
be worse first thing in the morning, or after exercise. It may be a constant
'dull' headache with spells when it gets worse.
Codeine is the most common cause of chronic daily
Codeine is the
worst culprit for chronic daily headache. Painkillers such as Solpadeine® and Nurofen Plus® which contain
codeine can bring on chronic daily headaches after only three days of use.
There is a serious problem in Ireland of people becoming dependent on
Nurofen Plus®, with
many people feeling they cannot “function” properly without taking a headache
How to break out of the cycle of chronic daily headaches
After stopping the regular use of
painkillers, you are likely to have worse and more frequent headaches for a
while. However, the frequency of headaches should then gradually return to
'normal'. Some people also feel sick, become anxious, or sleep
badly for a few days after the painkillers are stopped. Unfortunately, these
headaches and other withdrawal symptoms must be tolerated until the painkillers
are 'out of your system'.
Your pharmacist or doctor can help overcome this vicious circle.
For comprehensive and free health advice and information
call in to Whelehans, log on to www.whelehans.ieor dial 04493 34591. You can also e-mail queries to firstname.lastname@example.org.
This article was shortened for my blog, a longer version can be found at www.whelehans.ie or call in to Whelehans pharmacy Mullingar
Parkinson's disease is a long-term disorder of caused by
the degeneration of dopamine generating cells in the mid-section of the brain.
Its cause is unknown. Symptoms gradually worsen over time. The main symptoms
are stiffness, shaking (tremor) and slowing of movement.There is no cure but treatment can slow down
its progression and can provide good relief of symptoms for several years in
most patients. Modern treatment options means that people with Parkinson’s can
have a normal or near normal life expectancy.
Parkinson’s usually develops in people over the age of 50
and is rare in people under 50. It affects about 5 in 1,000 people in their 60s
about 40 in 1,000 people over 80. Men are one and a half times more likely to
get Parkinson’s than women.
With Parkinson’s, cells in the substantia nigra (the main
messaging area in the brain for controlling muscles) become damaged and die
over time. Dopamine, the main neurotransmitter becomes depleted due to
degeneration of this area which causes Parkinson symptoms.
The three main symptoms are slowness of movement,
stiffness and tremor.
Slowness of movement People may mistake this as a normal
part of aging which means diagnosis is delayed in many cases. With time, normal
walking becomes difficult and Parkinson’s patients often develop a 'shuffling'
type of walk with difficulty in starting, stopping, and turning.
Stiffness of muscles (rigidity) is when the muscles become
tense with the arms and legs tending not to swing as easily.
Tremor is common symptom of Parkinson’s. Not
all patients with Parkinson’s have tremor. About 30% of Parkinson’s patients do
not suffer from tremor initially but it always develops as the condition
progresses.It usually affects the
fingers, thumbs, hands, and arms but can affect any part of the body. Tremor is
worse when resting.
The speed in which symptoms become worse varies from
person to person. It can take several years before symptoms become bad enough
to affect routine tasks and quality of life. Other symptoms which can develop
include difficulty with balance and posture. Further symptoms include inability
to perform facial expressions like smiling or frowning; reduced blinking;
difficulty with fine movements such as using a scissors, tying shoelaces,
opening and closing buttons, zipping up and difficulty with writing (handwriting
tends to become smaller). There can be a slowdown in speech leading to a
monotone voice and swallowing difficulties can develop leading to pooling of
saliva in the mouth.
There is no cure for Parkinson’s but treatments can ease
symptoms and slow progression. It can take 8 to 10 weeks from the start of
treatment before the patient notices improvement in symptoms.
Levodopa tends to give a good improvement in symptoms.
Levodopa is converted to dopamine in the brain. The dose is started low but
tends to be increased to control symptoms. Levodopa is always used in
combination with another medicine to prevent side effects (either benserazide
or carbidopa). Brands available include Madopar® and Sinemet®.
Side effects from Levodopa tend to be rare at low doses. Nausea is the most
common side effect. Other side effects which may occur include vomiting,
dizziness, low blood pressure; however these often ease after a few days of
use. Levodopa can also cause movement disorders (head nodding, jerking and
twitches) if used at too high a dose. The effect of Levodopa tends to wear off
over time, usually over a period of 3 to 5 years.
Dopamine agonists mimic dopamine.Ropinirole (Requip®), pramipexole
(Mirapexin®) and rotigotine (Neupro® patch) are used most
commonly. Initial side-effects are similar to levodopa (nausea, vomiting and
dizziness) however side-effects tend to ease within a few days or weeks.
Despite being slight less effective than Levodopa, one potential advantage of
them as compared with levodopa is that they have less risk of causing movement
disorders (described above). A dopamine agonist may be used in combination with
levodopa as the condition gets worse. In trials comparing levodopa and dopamine
agonists, symptoms of Parkinson’s improved with levodopa by about 40 to 50% as
compared with approximately 30% with dopamine agonists.
Monoamine oxidase-B inhibitors
Sometimes used as alternative to levodopa for early
Parkinson’s. They include selegiline (Eldepryl®) and rasagiline
(Azilect®). They work by blocking the effect of monoamine-oxidase-B
(MAOB) in the brain, a chemical that prevents the breakdown of levodopa and
dopamine. Blocking the effect of MAO-B means the effect of dopamine lasts
longer. MAOBs are often used in combination with levodopa as the condition
Other medication used for Parkinson's
Catechol-O-methyltransferase (COMT) inhibitors have
become available in the last 20 years. Entacapone (Comtess® and also
an ingredient in Stalevo®) is an example. A COMT inhibitor is often
added to levodopa (as it increases its effect) when levodopa is not controlling
symptoms sufficiently alone or where the effect of levodopa wears off. This is
why Stalevo® has grown in popularity in recent years.
Non Drug options
A physiotherapist can advise and help with movement. They
will concentrate on posture, walking and exercises, thus maximising the length
the person can move and manage independently. An occupational therapist can
advise on areas that will make the person’s day to day living easier to manage
and will advise on home adaptations and devices which can simplify tasks that
become difficult due to the condition. A speech and language therapist can help
if difficulties with speech, swallowing or saliva occur; these difficulties
normally only occur later on in the condition.
Surgery will not cure Parkinson’s but may help ease
symptoms when medicines are not working well. An example is chronic deep brain
stimulation, a technique that involves putting a pulse generator (like a heart
pacemaker) in the chest wall. Clinical trials are still underway for this
therapy as long-term safety of this surgery is not certain so it is rarely used
at the moment.
Limit caffeine intake as caffeine can act as a diuretic
and increase the frequency of urination. Decrease fluids to either two hours
before bedtime, this will reduce waking up at night to use the bathroom. Sleep
deprivation can exacerbate symptoms of Parkinson's. At night, a portable urinal
and or bedpan can be an alternative to getting out of bed to make trips to the
bathroom which can be difficult. The shower area should be fitted with at least
It is easier to get up from a high chair than from a low
couch. Consider using Velcro fasteners instead of buttons; carrying a walking
stick when out can increase confidence if unsteadiness is a problem. Use an
electric toothbrush and razor to make brushing your teeth and shaving easier.
There are many utensils designed for people living with disability which can
make everyday chores like eating, preparing food easier, grooming and cleaning
easier. Examples include reaching devices, electric jar openers, modified cups
and utensils for ease of holding and use, the list is limitless. Ask your
occupational therapist or pharmacist for more details.
Longer term outlook
Symptoms tend to get worse with time but the speed of
progression may vary significantly from person to person. Many do not need
treatment initially as symptoms may be relatively mild. When symptoms become
worse, medication can give several years of good or reasonable control of the
symptoms. It is difficult to predict how quick the condition will progress.
Some people may only have mild symptoms 20 years after diagnosis with other
being disabled after only 10 years.
Disclaimer: Please ensure you consult with your healthcare professional before making any changes recommended
For comprehensive and free health advice and information call in to Whelehans, log on to www.whelehans.ieor dial 04493 34591. You can also e-mail queries to email@example.com.