Whelehans Health Blog

Friday, 21 June 2013

24 Hour Blood Pressure Monitor

High Blood Pressure is a silent killer

Did 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 deaths.

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 take.

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.

How 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

Contact 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

Sunday, 16 June 2013

Chronic Daily Headaches

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 arthritis.

Medication-overuse 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 headaches

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 Solpadeine® and Nurofen Plus®, with many people feeling they cannot “function” properly without taking a headache pill.

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.ie or dial 04493 34591. You can also e-mail queries to info@whelehans.ie.

Wednesday, 12 June 2013

Parkinson's Disease

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.

Profile of patients

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

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 progresses.

Other medication used for Parkinson's disease

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.

Practical tips

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 two handrails.

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.ie or dial 04493 34591. You can also e-mail queries to info@whelehans.ie.