he fits in the pantheon of the great tenors certainly he's one for the ages and. turner. starts july 10th. welcome to in good shape today's topics. pills or physio therapy what's better for your headache. is this compound found in cannabis have medical applications. and painkillers and there are side effects here's your host dr. hello and welcome to in good shape painting this is not

a bad thing in and of itself because it was that something wrong is going on inside your body but there's a problem when the pain gets chronic like an austere freitas migraines and then you have to see a pain doctor like doctor think here at the francisco's hospital in berlin and he's the head of the pain clinic. what's patients with severe chronic pain really need is a companion a professional companion who is helping them to fight the pain and to have a goal for the future. well i think we all have some pain medication at home and this is ok because if you've got a serious to say headache it's ok to take a pill but beware it's. and the danger is in some pain medications have serious

side effects and real harm in the body. because i know it's 4 years ago she became a patient in her own clinic for chronic pain have become unbearable. it's madson have been. able. to get. skin cancer and heart. to stand there and she was. as a happy something is she once. she's been through a lot of various doctors different therapies and lots of painkillers. but painkillers often have side effects. mind you if you think you can just keep treating pain yourself without going to a doctor and it's been going on for a long time you can get very dangerous. one reason is you might not be medicating

in the best way for the condition and the side effects can make your life difficult . and. the reason that painkillers like i'm p. profound and aspirin have side effect is due to the way they work injured enflame tissue releases certain fatty acids these are converted by so-called cox enzymes into messengers substances known as prostate gland in these messenger substances bind themselves to pain receptors at the nerve endings they transmit the pain signal to the central nervous system. profile an aspirin and some other drugs dampen the cox enzymes activity the body produces fewer prostitute landon's and the pain goes away across the land and also regulate other bodily functions like blood clotting liver function and the regeneration of mucus membranes in the gut. an overdose. of these over the counter painkillers can cause kidney damage liver

damage which in some cases then requires organ transplants and you can have stomach bleeding agents are also more at risk of having a stroke especially patients who already had a heart attack so they should be very cautious about these drugs. is also a patient at the pain clinic she has multiple sclerosis and has had severe back pain for years several operations didn't help. you're always looking around for something to relieve the pain so of course i took over the counter drugs my experience was that they didn't help. but the side effects were terrible. my stomachs in terrible shape i often have no appetite and have to throw up. because the side

effects were so bad doctors switched like enough to prescription opioids opioids act directly in the central nervous system and the brain there they block the transmission of pain signals between nerve cells opioids don't cause the typical side effects of over the counter pain killers but there's the threat of overdose and addiction and their effect also diminishes over time. that's what happened to take enough ick. this has to be opioid stopped having an effect that happens often so if you take opioids over a longer period of time they stop having the desired effect. so marcus youngblood doesn't prescribe either opioids or over the counter painkillers as a daily treatment for pain. instead he and his team of specialists therapists and psychologists develop tailor made treatment plans for each of their patients. as

his assistant is moms and. we give our patients a very thorough orthopedic examination from head to toe. it's not enough to simply look at an m.r.i. and say you have a herniated disc. or a constriction. especially with pain patients you have to take a holistic approach to get down to the different courses or consequences of. thank you enough doesn't need opioids anymore thanks to the therapy she received in a pain clinic she now only takes one medicine that cannabinoids spray but m.s. patients often prescribed. and i'm glad that it still gives me some relief it's the only thing that does i'm also very careful with it because i'm too afraid that something will happen again. i asked to see at. blitz and you know

now both know that painkillers can't heal you they can reduce the symptoms but in the long run they can also make you ill. just mankinds and really doesn't make sense to just take painkillers for 4 days wonder why it's not getting better and hope it will go away on its own that's not a good approach. to a book let's do some pain free but she's learned how to deal with the problem and she does exercises that help and definitely have no side effects. and. he's an anesthesiologist and a specialist and he medicine thanks for having me today and let's start this kind of consultation let's kick it off with a question. krista from lena writes that his girlfriend often has a headache and she always pops tablets to treat the head it's another the little concerned what the side effects so what do you think you have to take painkillers and headaches or where the limits are crossed of all i think it's to take pills

when you have severe pain because we have to function we won't be happy for life but we should not forget that these painkillers can every severe side effects especially if you go above the limited dozers but we have much smarter ways especially when we can change our lives or behavior they have exactly the same a life so you little bit conservative about this and say you can treat headaches in the different way not always with pills but as a g.p. i know that there's something like a pain memory what about we can avoid pain memory which can be biological. nerve damage and then the whole brain is changing the structure but this is quite rare and much more common is the social pain memory. where we change our behavior. and we changed our role from a normal person to the role of pain patients which is

a so-called social pain memory but sometimes you catch to take medication you have to take a pill and then there are side effects that can be stomach pain stomach ulcers that can be bleeding and they can also be problems with the heart and patients must know about that so it's about the non steroids pain medication yes but there are newer drugs of the same class which are safer for the stuff we have the so-called sips which would cause really less problems with the stomach but they have exactly the same problems for the heart so if you have patients so who have a severe heart disease coronary heart disease they should take these drugs only was a caution so sometimes as a doctor we have to switch from those kinds of medication to more centrally acting structures and drugs like opioids and so when we have to prescribe this are in general the opiates are not toxic so they do not cause damage to the internal

organs and. i prescribe them if i think they are useful so we try to determine a treatment goal. for example that the patients can have a better sleep at night that they can walk better. they can sit longer they can think better have more happiness in life and so we have this defined goal what we have and then we can we can figure out if with the help of these opioids we can attain this goal but addictive or can be addictive if they have a very rapid onset of action in the brain and this is if you take them intravenously or you take drops but if you take retouched tablets or plasters there's no problem at all but there isn't a crisis in the united states about 2000000 people got addicted and this is because the. prescribe. predetermining a treatment call i think and without any control of the patient the patient the

physician. patient to see a lot of patients. and it's always very important to find out what type of. testing headings daughter nicole and granddaughter mira have come to visit us. the 54 year old does her best to be there for her family. but the frequent pain she experiences means that even a simple meeting like this can be hard to keep. in the impersonal moment the worst thing is that the headaches come on at the most inconvenient times this into she doesn't even want that you may want to go out and then be hit with the image. i try to avoid public events because it's lots of hustle and bustle so few out. and that's too much of a strain for me. to. cast in suffered from different kinds of headaches

since she was a child and. over time they got worse. she's learned to identify what kind of headache is coming on. now she can put into words the type of pain that she is experiencing as a tension headaches all involved pressure not a hammering or anything like that more of a pressure as if you were wearing something tight wrapped around your head. and migraines come either from the right or the left and that's a kind of throbbing or hammering in your head. what. is happening nice to see you. these days she's managed to get the migraines under control thanks to a category of drugs called triptans. every 3 months she's given a low dosage injection of the neurotoxin botox to cause the botox.

clusters that play a role in migraine formation it also blocks neurotransmitters that can trigger migraine attack patients get injections every 3 months for most the migraine is reduced to a much more bearable level tweeting she is most. gifted also takes antidepressants to alleviate her tension headaches. these kinds of drugs can help some patients have fewer and less severe headaches. but even if they're less painful than before cast and still get tension headaches almost every day. for additional relief she goes to physio therapy. she suffers in particular from tension in her shoulder and neck a common complaint among patients with tension headaches. and. you have to take a closer look at the tension headache to see where the tension is coming from. tension

in the neck because somewhere else so you have to examine it very closely. it can have its roots in stress or anxiety disorders there are quite a few different causes. exercises that help strengthen core muscles can help ease neck tension but regular training is key over the years cancer and got used to taking painkillers on a daily basis but that itself took its toll. so i wish to comment in i used to take drugs constantly just to get through the day. and of course i had to find a way to stop because too many painkillers can cause even more headaches. and that's the opposite of what you want. with. closing down on pain killers wasn't easy but kept in house and given up she works full time

in a large section of thora see a big challenge for someone who is constantly in pain but she's found ways of coping. and if we are. in the past i would come home and do all the chores right away start i got up early in the morning and did everything. and if someone wanted something from me i didn't say no but now i'm taking a common approach. she now spends the evening touring things she enjoys the focus is on activities that help her to relax. we just saw in the report that pills cannot always solve the problem when it comes to chronic pain so how important psychological aspects and pain management. psychological aspects of very very important builds trust just working on ones from ethics specific small part of the pain. but we must know the pain is a. is just one aspect of the whole of the whole system of the human

and the human consists of a soul of emotions of feelings and of the body so if we want be successful see the patient as a whole unit which is complex and if you just create a small part of it this will not help could tell you what kind of factors complicate pain management on the biological side that we have neuropathy pain which is pain of the nerves which is very hard to treat but we also have. the knowledge that pains influence psychological problems which can be depression anxiety disorders post-traumatic stress disorder from soldiers etc and when we have patients who suffer from both sides from the biological side and from the psychological side we must take both aspects into consideration and treat both as pic parallel at the same time so here you are patiently and you offer a holistic approach to pain management so ho often does it happen that patients

have to stop taking pain medication altogether before you can treat them never. patients never have to stop any medication before they come to us because we offer at the same time we often you would type of treatment. and sometimes we decide together with the patient that it's wise to decrease the previous pharmacological treatment to go dog with a dose to replace it by a better type of treatment which can be another drug which can be a kind of psychological treatment so patients don't have to worry that if they come to you with it you take something away from them they never have to vary and they have to vary and see so it's a g.p.m. acquainted to 2 kinds of patients one which i'm quite hypochondriac if something's painful they just come to me and say i want to have some pain medication and on the other hand there are some patients who are really in pain they don't want to take anything so how do they decide when to see a doctor i think. patients go to a doctor if the things that will go to a doctor from my side as a physician not as

a patient i would say i would recommend if the pain is so such a big impact on my daily lives. and didn't pick the problems with sleeping with walking with happiness then i should try to visit a doctor because it's always good 1st to try to software problems by myself but if it's not working i should think of bards talk with somebody who is professional and you as a professional can you always heal pain no i cannot whether what they can or what i like to do is they like to listen to my patients i have a deep interest in their problems. really because i love this job and. butter and patients normally are very happy if we really talk about it if they have the feeling i understand them and most of the times we can help somehow by the complete complete turk was there all pain is not realistic unfortunately it's very

humble things for this very interesting talk and if you've got any questions to experts be sure to catch me in email. on the not coming show we'll be looking at time management many people suffer from time pressure in their lives sometimes you have too much time on your hands and then suddenly too little how can you keep it from slipping through your fingers like sand send your questions to in good shape d.w. dot com just right time management and the subject line we look forward to hearing from you. and aspirin day reduces the chances awfully hard to take or a stroke unfortunately that's a myth if you're healthy taking aspirin on a regular basis when you're healthy can be quite dangerous. over $10000000.00 people die each year from heart attacks and strokes.

these cardiovascular diseases are the number one cause of death worldwide. for decades aspirin was seen as an iffy. drug for preventing vascular disease and strokes. by the wonder drug is one of the most popular pills in the history of medicine. around the world millions of healthy people over 60 have been advised to take an aspirin a day to lower the risk of heart attack as a blood thinning medication it prevents blood clots from forming clots in the arteries veins and heart can cause heart attacks and strokes. so taking an aspirin a day for heart health would seem to make sense. but it's not that simple in fact the drug can have serious side effects. gastrointestinal specialist

mathias it explains. ask. aspirin is a medication that inhibits particular proteins in the stomach and the gastric mucosa but we need these proteins in order for the gastric mucosa to regenerate if that doesn't happen it's susceptible to injury condition of these injuries might start to believe climate difficulty. and austine kind of spooky so people who take aspirin on a regular basis could have an increased risk of bleeding from the lining of the stomach and does it really prevent cardiovascular disease. struck at the sort of the aspirin and reducing events in the elderly trials known as asprey looked at 20000 adults over 70 with various risk factors such as high blood pressure high cholesterol and diabetes. the aim was to see whether low dose aspirin 100 milligrams a day could prevent cardiovascular disease it showed that it led to

a minimal reduction in cardiovascular diseases such as heart attacks and strokes by . the asprey trial divided 20000 people into 2 randomized groups. over the course of several years one group was given aspirin every day the other group a placebo. the participants were unaware which group they belong to. a study showed that aspirin did not significantly reduce the risk of heart attacks or strokes when taken by older adults who hadn't experienced either condition before. the risk of serious bleeding among the aspirin takers was increased compared to the placebo group. in recent years the idea that aspirin protects against cancer has been gaining traction. the study looked into that as well. so want to show.

some types of clouds it actually transpired that there was an increase in the incidence of tumors the principle of primary prevention of cancer which is the prevention of tumors in the elderly couldn't be proven this week or so i'd say that aspirin has no overall effect on cancer prevention. all in all not be the wonder drug it's being touted as in particular as a preventative measure healthy people shouldn't be taking it for primary prevention of cardiovascular disease the risks far outweigh the benefits. but for those who have a history of heart attack or stroke there is indeed a proven benefit. sprint's blood thinning properties can help reduce the risk of repeated bent. for some it's

a medical silver bullet for others it's fake news and talking about the healing powers of help more specific it's active ingredient can be dire or short c.b.d. which is no intoxicating effect that may help against many ailments. c.b.d. is one of the active ingredients in cannabis it's touted as a remedy for all kinds of diseases but to the products actually help against migraine or even diabetes like the advertising promises. neurologist and natural health practitioner dr. has studied the issue he says more research is needed due. to the claims that it's an antioxidant and inflammatory effective in treating nausea and effective in inhibiting epileptic seizures are for the most part actually true. basic research has been done in the areas i just mentioned and there

are also individual clinical studies for example studies about people who have epilepsy that doesn't respond to other medicines but c.b.d. works. despite the positive benefits they haven't been enough studies done on the ones that were done were too small in scope and in some cases when their quality was lacking. those who draw the wrong conclusions from all the claims made these days could even harm their health rather than help it. if someone for example reads in a brochure about the anti diabetic effect of c.b.d. that it helps reduce blood sugar levels but it could give diabetic patients false hope when they might think they can reduce their insulin dose in the worst case scenario they do it without consulting a doctor they can put themselves at serious risk. in general advice is caution he wants his patients not to take large doses of c.b.d. . that's it from today.

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