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

When taking a trip, many people often have to factor in how their changing schedule will affect their regular medication routines. We asked our readers for their best advice on managing medications while travelling, and the response was overwhelming. Here's what they said. Kristeen Bon - 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. Diane Green - 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. Irene Varis - Always get a letter from my doctor, with all my prescriptions for when I get overseas. Saves you a lot of trouble! Helen Lunn - 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. Jancye Winter - Always pack in your carry on with prescriptions. Jenny Gordon - 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. Nina Thomas Rogers - Be organised with all your medicines before you leave. Image credits: Shutterstock

Travel Tips

More Australians are using their superannuation for medical procedures. But that might put their financial health at risk

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/neera-bhatia-15189">Neera Bhatia</a>, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a> A record number of Australians are accessing their superannuation early on compassionate grounds, mainly to fund their own medical procedures – or those of a family member. Some 150,000 Australians have used the scheme in the last five years. Nearly 40,000 people <a href="https://www.ato.gov.au/about-ato/research-and-statistics/in-detail/super-statistics/early-release/compassionate-release-of-super">had applications approved</a> in 2022-23, compared to just under 30,000 in 2018-19 – an increase of 47%. Some people think this flexible use of funds is a good way to ensure people can fund their own medical needs. But more transparency and better oversight is needed. <h2>What are compassionate grounds?</h2> Since July 2018, the Australian Tax Office has administered the early release of superannuation – meaning before <a href="https://www.ato.gov.au/individuals-and-families/super-for-individuals-and-families/super/withdrawing-and-using-your-super/super-withdrawal-options#Preservationage">retirement</a> – under certain circumstances, including compassionate grounds. <a href="https://www.ato.gov.au/individuals-and-families/super-for-individuals-and-families/super/withdrawing-and-using-your-super/early-access-to-super/access-on-compassionate-grounds/expenses-eligible-for-release-on-compassionate-grounds">Compassionate grounds</a> for you or your dependant (such as child or spouse) are: <ul> <li>medical treatment or transport</li> <li>modifying your home or vehicle to accommodate special needs for a severe disability</li> <li>palliative care for a terminal illness</li> <li>death, funeral or burial expenses</li> <li>preventing foreclosure or forced sale of your home.</li> </ul> The medical treatment must be for a life-threatening illness or injury, or to alleviate acute or chronic pain, or acute or chronic mental illness. The treatment cannot be “readily available” through the public system. Cosmetic procedures are excluded. You also have to prove you cannot afford to pay part or all of the expenses without accessing your super, for example, by spending your savings, selling assets or getting a loan. People who can access other funding for the expense, such as via the <a href="https://theconversation.com/lists-of-eligible-supports-could-be-a-backwards-step-for-the-ndis-and-people-with-disability-236578">National Disability Insurance Scheme</a>, are ineligible. <h2>Why are people using this scheme more?</h2> The ATO has not explained what is driving the surge. General cost-of-living pressures may play a role. People may have fewer savings to draw on for medical procedures. But the treatments most commonly being accessed using superannuation – fertility treatments, weight loss surgeries and dental care – point to other systemic issues. There have long been issues with IVF and <a href="https://theconversation.com/why-isnt-dental-included-in-medicare-its-time-to-change-this-heres-how-239086#:%7E:text=The%20real%20reason%20dental%20hasn,has%20a%20structural%20budget%20problem.">dental care</a> not being readily available or funded in the public health system. Weight loss surgeries (including <a href="https://www.mayoclinic.org/tests-procedures/bariatric-surgery/about/pac-20394258">bariatric surgery</a>) can help combat potentially life-threatening conditions such as heart disease. Recent <a href="https://www.monash.edu/news/articles/fewer-australians-having-bariatric-surgery-monash-university-led-report">research</a> suggests there has been an overall drop in the number of Australians having bariatric surgeries since 2016. But of those, 95% are performed through the private system. While early access to super can provide individuals access to critical treatment, there are issues with how compassionate grounds are defined and regulated. <h2>Lack of clarity</h2> As my co-author and I <a href="https://www.unswlawjournal.unsw.edu.au/wp-content/uploads/2021/06/Issue-442-PDF-3-Bhatia-and-Porceddu.pdf">have shown</a>, the vague wording of the <a href="https://www.legislation.gov.au/F1996B00580/2022-09-28/text">Superannuation Industry regulations</a> leaves them worryingly open to interpretation. For example, the meaning of “mental disturbance” is not defined. You may not meet the criteria of having an acute or life-threatening illness, or acute or chronic pain. But if you can show a certain condition causes you acute mental disturbance, you may qualify to release your superannuation early. People accessing their superannuation for IVF use this criterion, for example, by arguing they need to access funds to continue treatment and alleviate the acute mental distress caused by ongoing infertility issues. Two registered medical practitioners are each required to submit a report demonstrating the treatment is needed, and one must be a specialist in the field in which the treatment is required. However, the regulations do not specify clearly that the specialist should have relevant qualifications. In the IVF example, this means the specialist opinion can be provided by a fertility doctor rather than a mental health expert – and that person may stand to profit if they later also provide treatment. <h2>A closed-loop system</h2> Conflict of interest is another major issue. There is nothing in the regulations to stop a medical practitioner – such as a dentist – being involved in all steps and then financially benefiting. They could encourage a patient to access superannuation for a treatment, write the specialist report and then also receive payment for the treatment. Some clinics <a href="https://www.theguardian.com/australia-news/2024/apr/06/online-ads-promote-simple-access-to-super-to-pay-for-healthcare-despite-strict-rules">promote</a> accessing superannuation as an option to pay for expensive treatments. This raises important questions about the independence of the process, as well as professional ethics. Medical practitioners making recommendations for early release of superannuation should be doing so on genuinely compassionate grounds. But the potential for exploitation remains an ethical concern, when a practitioner can financially benefit from recommending early access to nest egg funds. Transparency around potential <a href="https://theconversation.com/people-are-using-their-super-to-pay-for-ivf-with-their-fertility-clinics-blessing-thats-a-conflict-of-interest-161278">conflicts of interest</a> are impossible to ensure without proper oversight. <h2>What is needed?</h2> 1. Mandatory financial counselling The ATO <a href="https://www.theage.com.au/healthcare/worrying-trend-record-number-of-australians-raid-super-to-fund-medical-treatments-20240920-p5kc44.html">has warned</a> accessing super early is not “free money”, with a spokesperson urging people to get financial advice. But the law should go a step further and make this compulsory. That way people making decisions during an emotionally charged moment can understand any future implications. 2. Tightening of the criteria Greater clarity in the legislation – such as defining “mental disturbance” – would help prevent loopholes being exploited. 3. Better oversight Less health-care industry involvement would promote greater transparency and independence. An independent body of medical practitioners could assess applications rather than practitioners who could financially benefit if applications are approved. This would help alleviate perceived and actual conflicts of interest. Accessing superannuation early may be the only option for some people to start a family or access other life-changing medical care. But they should be able to make this decision in a fully informed way, safeguarded from exploitation and aware of the implications for their future.<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/239588/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/neera-bhatia-15189">Neera Bhatia</a>, Associate Professor in Law, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a> Image credits: Shutterstock 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/more-australians-are-using-their-superannuation-for-medical-procedures-but-that-might-put-their-financial-health-at-risk-239588">original article</a>. </div>

Money & Banking

George Negus' son shares heartbreaking update on his dad's condition

The son of TV legend George Negus has shared a devastating update on his father's health, two years after his Alzheimer's <a href="https://oversixty.com.au/health/caring/tragic-diagnosis-for-news-and-media-legend" target="_blank" rel="noopener">diagnosis</a> was made public. In a heartbreaking post shared to LinkedIn, Ned Negus revealed that his father is now non-verbal due to his illness, and is living in an aged care facility in Sydney. “I was hesitant to post this on LinkedIn, as it’s pretty personal,” Ned, who is Chief Commercial Officer for the A-League, began in a lengthy post shared on Father’s Day. “But then realised you’re all humans and there’s always a place for sharing human realities with your professional network.” He continued, “For those of you who don’t know, my dad was diagnosed with Alzheimer’s around five years ago. He’s now non verbal most of the time (mind-blowing for me but also any of you that know him).” Along with his touching words, Ned shared a photo of him and his father embracing in a hug as they took a walk along the beach, recalling the heartfelt moment with his dad. “He was clearly not sure why this particular walk was symbolic and sometimes not sure with whom he was walking,” Ned shared, before adding that his dad “smiled broadly and then hugged me for quite some time”. “It was sad, but it was uplifting to know that even when you can no longer say what you feel, you can still DO what you feel. Love you Negsy.” Ned ended his emotional post by all paying tribute to his mother for her endless love and care for his dad. “P.s. My mum took this photo and is by his side most days helping him through, helping him remember (even the slightest thing) and feel. Massive shout out to her too,” he concluded. In 2022, the Negus family revealed George's diagnosis, sharing that he had been living in care home since 2021. “As a family, we are sharing the new path we walk as George faces the realities of his diagnosis of dementia from Alzheimer’s disease,” they wrote in a statement at the time. “We continue to share wonderful family times and are grateful for the care and support we have had from extended family and friends over the past few years who understand our challenges.” Image credits: Getty Images / LinkedIn

Caring

Doting dad sells everything he owns to develop cure for son's "incurable" condition

A dedicated father has drained his life savings to help find a cure for his son's "incurable" disorder. Terry Pirovolakis, a 44-year-old IT director, was hellbent on finding a cure for his six-year-old son Michael after he was diagnosed with Spastic paraplegia 50 (SPG50): a degenerative neurological condition that affects less than 100 people worldwide. SPG50 affects children's development, leading to cognitive impairment, muscle weakness, and paralysis over the course several years, often ending in death usually before a patient reaches the age of 30. "They said he'd never walk or talk, and would need support for the rest of his life," he recalled of the 2018 diagnosis. "They told us to just go home and love him - and said he would be paralysed from the waist down by age 10, and quadriplegic by age 20," he continued. Determined to save his son, Terry drained his life savings to start researching potential cures rooted in gene therapy, after reading countless journals on the subject and meeting with experts around the world. Terry said, "We then liquidated our life savings, refinanced our home and paid a team at the University of Texas Southwestern Medical Center to create a proof of concept to start Michael's gene therapy." The father soon signed a contract to start a gene therapy program, consisting of injecting cerebral spinal fluid into the patient's back, and after years of lab work, the treatment started to take, and on December 30th 2021, the government <a id="mol-70453400-6948-11ef-9b54-1d20db350cbd" href="https://www.dailymail.co.uk/news/canada/index.html" target="_self"></a>moved it forward. "On March 24, 2022, my son was the first person to ever get treated with gene therapy at SickKids in Toronto," Pirovolakis, a father of three, told Fox News in detailing his medical odyssey. Michael was the first to receive his father's one-time treatment, after Pirovolakis quit his job and started a nonprofit in California to devote himself to the cause. The company, named Elpida Therapeutics, after the Greek word for 'hope', now has five employees and 20 consultants, with Michael now on the mend. Since being treated, the youngster's condition seems to have stabilised, and he is now able to use a device to communicate with his family and caregivers. Another three children who were able to receive the remaining doses from Pirovolakis' first batch, as the drug still costs about $1million to make for each child, are also seeing positive results. "When I heard that no one was going to do anything about it, I had to - I couldn't let them die," Pirovolakis said. "We decided that we had to help other kids." Despite it being approved, big pharmaceutical companies have been slow to manufacture the drug, with several firms rejecting the prospect when proposed, Pirovolakis said "No investor is going to give you money to treat a disease that is not going to make money," he said. "That's the dilemma we're in." Pirovolakis said that when his son was diagnosed, he was told the boy would be paralysed from the waist down by the age of ten and quadriplegic by the age of 20, forcing the father to do everything he can. "We were told he would never speak or walk, and that he will have severe developmental delays. I just couldn't accept that fate for my child," he said. "The technology to cure our children is already here. I hope that someone with immense wealth - and more importantly, the vision and influence - will step in." Image credits: Facebook

Money & Banking

John Boland’s battle against prostate cancer and the urgent need for reform

John Boland, a 74-year-old retired Navy Reserve Lieutenant Commander, found himself at a crossroads – a place where hope and despair often meet in the lives of those battling life-threatening illnesses like prostate cancer. Diagnosed five years ago, John’s journey has been a relentless fight against a disease that, despite medical advancements, still claims the lives of 10 men in Australia every day. After undergoing surgery and 37 rounds of radiation therapy, John’s battle was far from over. His PSA (Prostate-Specific Antigen) levels, an indicator of prostate cancer activity, were not dropping sufficiently, signalling that the fight was only getting tougher. It was then that John was introduced to a groundbreaking treatment: Lutetium-177 PSMA therapy (LuPSMA), a targeted radionuclide therapy with pinpoint accuracy to attack cancer cells. This innovative treatment offered a glimmer of hope, a chance to strike at the heart of the disease that had disrupted his life. But there was a catch – the cost. Each round of LuPSMA treatment costs $10,000, and while some patients may require up to eight rounds, John’s doctors recommended two based on his response. Even so, the financial burden was immense, forcing John to dip into his superannuation, ultimately spending $60,000 on the treatment that was not covered by insurance. Despite the financial strain, the results were nothing short of miraculous. After just the first round, John’s PSA levels dropped by a staggering 95%. After the second, they fell to nearly zero. The treatment had not only attacked the cancer but had also restored his quality of life, allowing him to once again enjoy the simple pleasures – time with family, daily activities and even golf. It was a victory that brought renewed hope and confidence for the future, a victory that made the $60,000 investment worth every cent. “My case was remarkably successful after the second treatment, which are eight weeks apart, after the scan had no cancer, and my PSA was effective to zero. So it was a reliable result for me and a huge boost, but unfortunately, they're $10,000 a time, and you can require up to eight treatments,” says John. “Fortunately we were able to fund it from our superannuation pension account, the $20,000, but I imagine that a lot of people, they can’t find that $20,000.” But John’s story, while inspiring, also highlights a grim reality: many Australians are not as fortunate. The LuPSMA treatment that worked so well for John remains out of reach for many others due to its prohibitive cost. And this isn’t just an isolated issue; it’s a systemic problem affecting thousands of men across the country. A new report, the <a href="https://www.pcfa.org.au/media/nbennwom/aus-np-1123-80001-amgen-access-gap-report_april-2024-data-final-approved.pdf" target="_blank" rel="noopener">Australian Patient Access Gap Report</a>, has shed light on the alarming delay in the public availability of new medicines in Australia. The report reveals that Australians with life-threatening illnesses are waiting an average of 591 days – more than 18 months – for access to new, potentially life-saving medicines. For some, the wait can be as long as three years. These delays are not just statistics; they represent real people, real lives hanging in the balance. The Prostate Cancer Foundation of Australia (PCFA), the country’s leading organisation in the fight against prostate cancer, is calling for urgent reform. They argue that the current system, which often requires multiple rounds of review before new treatments are approved for public use, is failing Australians. PCFA CEO Anne Savage points out that while 10 men die from prostate cancer every day, the approval process for new treatments drags on, leaving patients like John Boland to fend for themselves – often at great financial and emotional cost. “In almost every instance, Australians are being denied access to new medicines that can extend and save their lives, simply because our approval systems have not kept up with the pace of change,” she says. “In relation to prostate cancer, applications typically undergo two or three rounds of review before achieving a positive recommendation, while 10 men die a day from the disease. It’s simply not good enough.” John’s story serves as a strong call to action. His successful treatment with LuPSMA is a testament to the power of modern medicine, but it also underscores the urgent need for change. No one should have to choose between their life savings and their life; it’s time for Australia to modernise its pharmaceutical benefits scheme, ensuring that all Australians, regardless of their financial situation, have access to the treatments they need. As we move forward, the PCFA is urging Australians to take part in initiatives like <a href="https://www.thelongrun.org.au/" target="_blank" rel="noopener">The Long Run</a> during Prostate Cancer Awareness Month in September, raising awareness and funds to support the fight against this devastating disease. For John Boland, and for the thousands of others who share his struggle, we must work towards a future where no one is left behind in the fight against cancer. Image: Courtesy of John Boland.

Caring

Gold medallist sleeps in Paris park to protest "disappointing" Olympic village conditions

A gold medallist has been spotted sleeping in a Paris park in protest of the conditions in the Olympic village. Italian swimmer Thomas Ceccon was captured sleeping atop a white towel in a park located inside the Olympic village by Saudi rower Husein Alireza. Alireza posted the photo to Instagram with the caption, "Rest today, conquer tomorrow." The Italian swimmer, who won gold in the 100m backstroke, had already complained publicly about the accommodations in the Olympic Village, after he failed to reach the 200m backstroke final on Wednesday. Since the commencement of the Paris Games, many athletes have spoken out about the conditions in the Olympic village, saying the beds are uncomfortable, the rooms are poorly air conditioned and the food is poor quality. “There is no air-conditioning in the village, it’s hot, the food is bad,” Ceccon said, according to <a href="https://www.thesun.co.uk/sport/29673636/thomas-ceccon-sleeping-park-conditions-olympic-village-paris/" target="_blank" rel="noopener">The Sun. </a> “Many athletes move for this reason: it’s not an alibi or an excuse, it’s the reality of what perhaps not everybody knows." “I’m disappointed that I didn’t make the final, but I was too tired. It’s hard to sleep both at night and in the afternoon. Here, I really struggle between the heat and the noise.” Andy Anson, the chief of the British Olympic Association, also voiced concerns about how the quality of the village is affecting athletes, telling The Times of London, “There are not enough of certain foods: eggs, chicken, certain carbohydrates.” “And then there is the quality of the food, with raw meat being served to athletes.” A number of athletes, including the entire US women’s tennis team (with the exception of Coco Gauff) have left the village and searched for alternate accommodation for the duration of the Games. Image credits: Instagram/Panoramic/SIPA/SIPA/Shutterstock Editorial

Travel Trouble

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

<div class="theconversation-article-body"> <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> Migraine is many things, but one thing it’s not is “just a headache”. “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. 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. 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. <h2>What’s happening in my brain?</h2> The biological basis of migraine is complex, and varies according to the phase of the migraine. Put simply: The earliest phase is called the prodrome. 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. <figure class="align-center "><img src="https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=754&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&q=45&auto=format&w=600&h=485&fit=crop&dpr=1 600w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=485&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=485&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=610&fit=crop&dpr=1 754w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=610&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=610&fit=crop&dpr=3 2262w" alt="" /><figcaption>The hypothalamus is shown here in red. <a class="source" href="https://www.shutterstock.com/image-vector/brain-cross-section-showing-basal-ganglia-329843930">Blamb/Shutterstock</a></figcaption></figure> Next is the aura phase, 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. In the headache phase, 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. Finally, the postdromal phase occurs after the headache resolves and commonly involves changes in mood and energy. <h2>What can you do about the acute attack?</h2> 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. <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> Aspirin 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. Triptans 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. Triptans vary by their route of administration (tablets, wafers, injections, nasal sprays) and by their time to onset and duration of action. 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). As triptans constrict blood vessels, they should be used with caution (or not used) in patients with known heart disease or previous stroke. Gepants 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”. 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. They do not cause blood vessel constriction and can be used in patients with heart disease or previous stroke. Ditans 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. 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. <h2>What about preventing migraines?</h2> 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. 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. 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: <ul> <li>tablets that lower blood pressure (candesartan, metoprolol, propranolol)</li> <li>antidepressants (amitriptyline, venlafaxine)</li> <li>anticonvulsants (sodium valproate, topiramate).</li> </ul> Some people have none of these other conditions and can safely start medications for migraine prophylaxis alone. 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. 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. <hr /> <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> <hr /> <h2>‘Nothing works for me!’</h2> 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. 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. 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. 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. 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. 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.<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" /> <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> Image credits: Shutterstock 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>. </div>

Body

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

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/caroline-sirois-1524891">Caroline Sirois</a>, <a href="https://theconversation.com/institutions/universite-laval-1407">Université Laval</a> 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? 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). 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. <h2>Polypharmacy among older adults</h2> 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. Is it a good idea to take so many drugs? 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. 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. <h2>The risks of polypharmacy: 5 points to consider</h2> When we evaluate cases of polypharmacy, we find that the quality of treatment is often compromised when many medications are being taken. <ol> <li> Drug interactions: polypharmacy increases the risk of drugs interacting, which can lead to undesirable effects or reduce the effectiveness of treatments. </li> <li> 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? </li> <li> 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. </li> <li> 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. </li> <li> 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. </li> </ol> 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. 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. <h2>3 tips to avoid the risks associated with polypharmacy</h2> What can we do as a patient, or as a caregiver? <ol> <li> 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 ? </li> <li> 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? </li> <li> 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. </li> </ol> <h2>Benefits should outweigh the risks</h2> 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. 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" /> <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> Image credits: Shutterstock 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>. </div>

Body

Grandmother in critical condition after stabbing

A grandmother is in hospital in a critical condition after she was stabbed multiple times in an alleged DV incident in Perth's east. Police were called to a home on Jessie Road in Gooseberry Hill just after 5pm on Wednesday after neighbours allegedly heard 60-year-old Paulette Mountford's screams. Nine News reported that her neighbours found her in the garden and were attempting to apply pressure to her neck and body before paramedics arrived. She was rushed to hospital where she underwent emergency surgery and remains in a serious but stable condition. Christopher John Sullivan, 72, was taken into custody at the property before being charged with one count of attempt to unlawfully kill. Her alleged attacker reportedly barricaded himself inside the home before tactical response officers negotiated for him to leave. Mountford is a church volunteer who has helped support victims of domestic violence. In a statement, her daughters said: "We are devastated and utterly heartbroken that our dear mother has endured such a horrifying ordeal." "All we want is for our mother to overcome her injuries." They also thanked everyone who rushed to her aid and those who are continuing to care for her. “For such a kind-hearted person to suffer so deeply is hard for us to understand," they said. “All that we want at this time is for our mother to overcome her injuries, and we pray and hope that she gets better soon. “She is a strong woman and we know she will be using all her strength to get better.” Sullivan appeared before the Perth Magistrates Court on Wednesday charged with attempted murder. He told the magistrate he intended to plead guilty but no official plea was entered, and the matter was stood down while he was provided legal advice. He did not apply for bail and was remanded in custody. Image: Nine

Legal

Shannon Noll postpones show due to medical emergency

Shannon Noll has been forced to postpone two of his upcoming shows in Victoria due to a medical emergency. The former Australian Idol winner, 48, took to Instagram to announce that he had to undergo an "emergency procedure" although the exact details of the procedure was kept under wraps. "Hi guys, due to unforeseen circumstances I'm afraid I have to postpone this weekend's shows at Thornbury Theatre and West Gippsland Arts Centre," he began on the post shared on Friday. "I'm so sorry to do this but I had to undergo an emergency procedure yesterday that now prevents me from travelling for the next few days. "Huge apologies again everyone but I look forward to seeing you all at the rescheduled shows soon!" he concluded. Fans took to the comments to wish the star a speedy recovery. "Health comes first, wishing you a speedy recovery," one wrote. "Hope you are back to good health quickly Shannon. All the very best," another added. "Health is the absolute priority - we hope that you’re back fit and fighting very soon!" a third commented. "Get well soon Shannon! Take the time you need to recover," added a fourth. It has been 20 years since the singer rose to fame after becoming a runner-up on the first season of Australian Idol. "To still be a professional musician travelling the country and playing music 20 years later after a singing competition, I'm so thankful and blessed," he told 9Honey. "And it's all because of the support the Australian public has given me over the years, during the ups and downs as well." "It's all because of the public. I'm thankful to them and will be forever," he added. Image: Getty

Caring

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

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. <div class="copy"> 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. 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. 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’. 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?’ 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. 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. “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. “But given this occurs whether the evidence given is correct or not, perhaps the evidence adds too much noise, thus lowering accuracy.” 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. “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. 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. “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.” Image credits: Getty Images <div> <noscript data-spai="1"><img decoding="async" class="aligncenter size-full wp-image-198773" src="https://cdn.shortpixel.ai/spai/q_lossy+ret_img+to_auto/cosmosmagazine.com/wp-content/uploads/2023/12/MICROSCOPIC-TO-TELESCOPIC__Embed-graphic-720x360-1.jpg" data-spai-egr="1" width="600" alt="Buy cosmos print magazine" title="asking chatgpt a health-related question? better keep it simple 2"></noscript> </div>  <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&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" /><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>. </div>

Caring

Embracing healing: The rise of medical cannabis in Australia

In recent years, Australia has made significant strides in healthcare, particularly in the realm of alternative medicine. One such breakthrough gaining widespread recognition is the availability and utilisation of medical cannabis. <a href="https://www.oversixty.com.au/health/body/how-nurses-are-changing-the-conversation-around-medicinal-cannabis" target="_blank" rel="noopener">As attitudes shift and research unfolds</a>, the once-stigmatised plant is emerging as a source of genuine hope and relief for patients across the country. Medical cannabis, derived from the cannabis plant, contains compounds known as cannabinoids, notably THC (tetrahydrocannabinol) and CBD (cannabidiol), which possess therapeutic properties. While recreational use remains a contentious issue, the medicinal potential of cannabis cannot be overlooked. In Australia, its legal status has evolved; in October 2016 the Australian Government changed the law to allow organisations to grow cannabis for research and to make pharmaceutical products, allowing patients to access cannabis-based products under specific conditions. One of the most significant benefits of medical cannabis is its ability to alleviate symptoms and improve the quality of life for patients suffering from various medical conditions. From chronic pain and epilepsy to nausea induced by chemotherapy, medical cannabis offers relief where traditional treatments can fall short or have significant long-term side effects. For people with debilitating illnesses, this alternative therapy can open doors to a life with reduced discomfort and enhanced well-being. Moreover, the availability of medical cannabis fosters a more patient-centric approach to healthcare. By recognising the diverse needs of individuals and offering alternative treatment options, healthcare professionals empower patients to take control of their health journey. This shift towards personalised medicine acknowledges that what works for one person may not work for another, and cannabis-based treatments provide another tool in the arsenal of healthcare interventions. Australia's embrace of medical cannabis also extends to research and innovation. With an increasing number of clinical trials and studies exploring its efficacy and safety, the medical community is uncovering new insights into the potential applications of cannabis-based therapies. This commitment to scientific inquiry ensures that medical cannabis is integrated into healthcare practices responsibly and ethically. Furthermore, the legalisation of medical cannabis opens doors for economic growth and innovation. Australia's burgeoning cannabis industry has the potential to create jobs, stimulate investment and drive technological advancements in cultivation, processing and distribution. By capitalising on this emerging market, Australia can position itself as a global leader in medical cannabis research and production. Take the example of <a href="https://www.montu.com.au/" target="_blank" rel="noopener">Montu</a>, a Melbourne-based medical cannabis company that in November was <a href="https://www.montu.com.au/_files/ugd/0ee6ca_f78badef1cf64ccba22263ed6b5ea5d0.pdf" target="_blank" rel="noopener">named the fastest-growing tech company</a> in the entire country for the second consecutive year. The groundswell of public and investor support for such a company – whose stated mission is to deploy technology to create a better medical cannabis ecosystem for suppliers, practitioners, pharmacies and the patients they serve – is testament to the rapidly growing popularity of medical cannabis as a viable everyday resource for health and wellbeing. Companies like Montu that are streamlining and regulating access to medical cannabis via a growing network of medical practitioners are playing a vital role in getting help for those who need it most. Even though Montu was only formed in 2019, with its first products entering the market in 2020, the evolution of its company ecosystem has been dramatic to say the least. Now with a diverse range of companies under its umbrella, Montu is using innovative solutions to enhance the patient experience – from their "Leafio" dispensing system bridging the gap between suppliers and pharmacies, to their growing variety of products and brands, to their "Alternaleaf" telehealth service that connects patients with expert clinicians, and their high-end "Saged" professional online learning portal for healthcare professionals, this integrated approach is shaping a future where medical cannabis is accessible, efficient and tailored to meet the diverse needs of patients and healthcare providers alike. Perhaps most importantly of all, the availability of medical cannabis promotes harm reduction by offering a safer alternative to potentially addictive pharmaceutical drugs. For patients struggling with opioid dependence or other addictive substances, cannabis-based treatments provide a non-addictive option for managing symptoms, reducing the risk of substance abuse and overdose. The legalisation of medical cannabis in Australia marked a pivotal moment in the nation's healthcare landscape. With growing recognition of the therapeutic potential of cannabis-derived treatments, Australia has taken decisive steps to ensure that patients in need have access to this alternative therapy. Through rigorous regulation and oversight, the legal framework surrounding medical cannabis balances patient safety with the need for compassionate care, allowing individuals suffering from debilitating conditions to explore new avenues of treatment. This landmark decision not only reflected a shift in societal attitudes towards cannabis but also underscored Australia's commitment to evidence-based medicine and the well-being of its citizens. As attitudes towards cannabis evolve and its medicinal benefits become more widely recognised, Australia stands at the forefront of a healthcare revolution – one of hope, healing and a future where patients can experience relief and improved quality of life. Image: Getty

Caring

Attempts to access Kate Middleton’s medical records are no surprise. Such breaches are all too common

<a href="https://theconversation.com/profiles/bruce-baer-arnold-1408">Bruce Baer Arnold</a>, <a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</a> The <a href="https://www.abc.net.au/news/2024-03-20/claim-hospital-staff-tried-to-access-kate-middleton-health-info/103608066">alleged</a> data breach involving Catherine, Princess of Wales tells us something about health privacy. If hospital staff can apparently access a future queen’s medical records without authorisation, it can happen to you. Indeed it may have already happened to you, given many breaches of health data go under the radar. Here’s why breaches of health data keep on happening. <h2>What did we learn this week?</h2> Details of the alleged data breaches, by <a href="https://www.mirror.co.uk/news/royals/breaking-kate-middleton-three-london-32401247">up to three staff</a> at The London Clinic, emerged in the UK media this week. These breaches are alleged to have occurred after the princess had abdominal surgery at the private hospital earlier this year. The UK Information Commissioner’s Office <a href="https://ico.org.uk/about-the-ico/media-centre/news-and-blogs/2024/03/ico-statement-in-response-to-reports-of-data-breach-at-the-london-clinic/">is investigating</a>. Its report should provide some clarity about what medical data was improperly accessed, in what form and by whom. But it is unlikely to identify whether this data was given to a third party, such as a media organisation. <h2>Health data isn’t always as secure as we’d hope</h2> Medical records are inherently sensitive, providing insights about individuals and often about biological relatives. In an ideal world, only the “right people” would have access to these records. These are people who “need to know” that information and are aware of the responsibility of accessing it. Best practice digital health systems typically try to restrict overall access to databases through hack-resistant firewalls. They also try to limit access to specific types of data through grades of access. This means a hospital accountant, nurse or cleaner does not get to see everything. Such systems also incorporate blocks or alarms where there is potential abuse, such as unauthorised copying. But in practice each health records ecosystem – in GP and specialist suites, pathology labs, research labs, hospitals – is less robust, often with fewer safeguards and weaker supervision. <h2>This has happened before</h2> Large health-care providers and insurers, including major hospitals or chains of hospitals, have a <a href="https://www.theguardian.com/australia-news/2023/dec/22/st-vincents-health-australia-hack-cyberattack-data-stolen-hospital-aged-care-what-to-do">worrying</a> <a href="https://www.afr.com/technology/medical-information-leaked-in-nsw-health-hack-20210608-p57z7k">history</a> of <a href="https://www.innovationaus.com/oaic-takes-pathology-company-to-court-over-data-breach/">digital breaches</a>. Those breaches include hackers accessing the records of millions of people. The <a href="https://www.theguardian.com/world/2022/nov/11/medical-data-hacked-from-10m-australians-begins-to-appear-on-dark-web">Medibank</a> data breach involved more than ten million people. The <a href="https://www.hipaajournal.com/healthcare-data-breach-statistics/">Anthem</a> data breach in the United States involved more than 78 million people. Hospitals and clinics have also had breaches specific to a particular individual. Many of those breaches involved unauthorised sighting (and often copying) of hardcopy or digital files, for example by nurses, clinicians and administrative staff. For instance, this has happened to public figures such as <a href="https://www.latimes.com/archives/la-xpm-2008-mar-15-me-britney15-story.html">singer</a> <a href="https://journals.lww.com/healthcaremanagerjournal/abstract/2009/01000/health_information_privacy__why_trust_matters.11.aspx">Britney Spears</a>, actor <a href="https://www.nytimes.com/2007/10/10/nyregion/10clooney.html">George Clooney</a> and former United Kingdom prime minister <a href="https://www.theguardian.com/uk-news/2024/mar/20/when-fame-and-medical-privacy-clash-kate-and-other-crises-of-confidentiality">Gordon Brown</a>. Indeed, the Princess of Wales has had her medical privacy breached before, in 2012, while in hospital pregnant with her first child. This was no high-tech hacking of health data. Hoax callers from an Australian radio station <a href="https://theconversation.com/did-2day-fm-break-the-law-and-does-it-matter-11250">tricked</a> hospital staff into divulging details over the phone of the then Duchess of Cambridge’s health care. <h2>Tip of the iceberg</h2> Some unauthorised access to medical information goes undetected or is indeed undetectable unless there is an employment dispute or media involvement. Some is identified by colleagues. Records about your health might have been improperly sighted by someone in the health system. But you are rarely in a position to evaluate the data management of a clinic, hospital, health department or pathology lab. So we have to trust people do the right thing. <h2>How could we improve things?</h2> Health professions have long emphasised the need to protect these records. For instance, medical ethics bodies <a href="https://www.bmj.com/content/350/bmj.h2255">condemn</a> medical students who <a href="https://www.abc.net.au/news/2014-04-14/picture-sharing-app-for-doctors-raises-privacy-concerns/5389226">share</a> intimate or otherwise inappropriate images of patients. Different countries have various approaches to protecting who has access to medical records and under what circumstances. In Australia, for instance, we have a mix of complex and inconsistent laws that vary across jurisdictions, some covering privacy in general, others specific to health data. There isn’t one comprehensive law and set of standards <a href="https://theconversation.com/governments-privacy-review-has-some-strong-recommendations-now-we-really-need-action-200079">vigorously administered</a> by one well-resourced watchdog. In Australia, it’s mandatory to report <a href="https://www.oaic.gov.au/privacy/notifiable-data-breaches">data breaches</a>, including breaches of health data. This reporting system is currently <a href="https://theconversation.com/governments-privacy-review-has-some-strong-recommendations-now-we-really-need-action-200079">being updated</a>. But this won’t necessarily prevent data breaches. Instead, we need to incentivise Australian organisations to improve how they handle sensitive health data. The best policy <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/1475-4932.12693">nudges</a> involve increasing penalties for breaches. This is so organisations act as responsible custodians rather than negligent owners of health data. We also need to step-up enforcement of data breaches and make it easier for victims to sue for breaches of privacy – princesses and tradies alike.<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/226303/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/bruce-baer-arnold-1408">Bruce Baer Arnold</a>, Associate Professor, School of Law, <a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</a> 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/attempts-to-access-kate-middletons-medical-records-are-no-surprise-such-breaches-are-all-too-common-226303">original article</a>. Images: Getty

Legal

Popular TV host diagnosed with same condition as Bruce Willis

Popular American TV host Wendy Williams has shared her diagnosis after being plagued by "hurtful rumours". The 59-year-old's medical team announced in a lengthy statement that she has been diagnosed with aphasia and frontotemporal dementia: the same conditions actor Bruce Willis is battling. The news comes after Williams' family confirmed she had checked in to a facility to treat cognitive issues. “Questions have been raised at times about Wendy’s ability to process information and many have speculated about Wendy’s condition, particularly when she began to lose words, act erratically at times, and have difficulty understanding financial transactions,” her medical team said. They said Williams' symptoms first began in 2023, and was diagnosed with the neurological conditions just weeks later after undergoing a series of tests. Her team said both conditions have “already presented significant hurdles in Wendy’s life”. “Wendy would not have received confirmation of these diagnoses were it not for the diligence of her current care team, who she chose, and the extraordinary work of the specialists at Weill Cornell Medicine,” they said. “Receiving a diagnosis has enabled Wendy to receive the medical care she requires.” Williams chose to share the news to “advocate for understanding” and to “raise awareness” for the difficult conditions. “Unfortunately, many individuals diagnosed with aphasia and frontotemporal dementia face stigma and misunderstanding, particularly when they begin to exhibit behavioural changes but have not yet received a diagnosis,” her team said. “There is hope that with early detection and far more empathy, the stigma associated with dementia will be eliminated, and those affected will receive the understanding, support, and care they deserve and need." “Wendy is still able to do many things for herself. Most importantly she maintains her trademark sense of humour and is receiving the care she requires to make sure she is protected and that her needs are addressed." “She is appreciative of the many kind thoughts and good wishes being sent her way.” The TV presenter has previously been open with her medical battle with Graves’ disease and lymphedema, as well as other significant challenges related to her health. Image credits: Getty Images

Caring

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

<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> 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. But you may not be aware that mixing certain medicines with alcohol can increase the effects and put you at risk. 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. <h2>How alcohol and medicines interact</h2> 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. <iframe id="JCh01" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/JCh01/1/" width="100%" height="400px" frameborder="0"></iframe> 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. 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. 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>. 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. Combining alcohol with ibuprofen can lead to a higher risk of stomach upsets and stomach bleeds. 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>. 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. <h2>Who is at most risk?</h2> 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. 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>. 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. 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. <h2>What drugs can’t you mix with alcohol?</h2> 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. 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. 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. 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. If you do want to drink alcohol while being on medication, discuss it with your doctor or pharmacist first.<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" /> <a href="https://theconversation.com/profiles/nial-wheate-96839">Nial Wheate</a>, 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> Image credits: Getty Images 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>.

Body

More than a third of people with dementia don’t know they have it – what to do if you suspect your partner has the condition

<a href="https://theconversation.com/profiles/kate-irving-1493654">Kate Irving</a>, <a href="https://theconversation.com/institutions/dublin-city-university-1528">Dublin City University</a> Around <a href="https://www.bbc.co.uk/news/uk-england-67613465">36% of people</a> in England with dementia are unaware they have the condition, according to a new report from the Dementia Commission. <a href="https://chamberuk.com/wp-content/uploads/2023/12/231127-Dementia-Commission-Report-Embargoed.pdf">The report</a> suggests things health and care professionals can do to improve spotting early signs of dementia. But what can you do if you think your partner has the condition? And how can you broach the topic with them? If you are worried about your partner having dementia, here are some useful things to know. Dementia is a term for a range of diseases (for example, Alzheimer’s) which develop over time (months and years) and cause problems with memory and reasoning, communication, changes in personality and a reduction in a person’s ability to carry out daily activities, such as shopping, washing, paying bills or cooking. Dementia can present very differently in each person, so it’s about knowing what’s normal for your loved one. A person who has always been conscientious and organised starting to unravel is very different from a scatterbrained person just being slightly more scatterbrained. Grief and stress can affect memory yet not be the start of dementia. But they can also mask the start of dementia: we call this “diagnostic over-shadowing”. There are also age-related changes to cognition. For example, we take longer to learn when we get older. But a one-off event – no matter how dramatic – is not necessarily dementia. It’s about looking for a pattern of decline. If you see these changes happen in a short space of time (weeks or days) it is unlikely to be dementia and could be something more serious. This requires urgent investigation by a doctor. <h2>Greatest fear</h2> Dementia is one of the greatest fears of our age. The horror of perceived loss of self can cause people to avoid discussing the issue, discussing it in an unhelpful way (such as criticising or inadvertently humiliating) or discussing it with other relatives, but not the person they are noticing changes in. Over time, this can cause a lack of trust to develop. Discussing memory problems openly with the person at the point of a memory failure or if they raise the concern is best. Of course, it takes courage and makes us face our own vulnerability. Sometimes the person will be in denial or lack insight into the memory problems (this can be a symptom of dementia, but isn’t always). If someone raises a concern about their memory issues, I would urge you not to minimise this, as it probably took courage to admit their concerns. I heard a relative say to my mother: “Oh, you left the pot on the stove. I lost the car in the multistory the other day.” My mother had dementia – the relative did not. If they are adamant that they do not have concerns, this is harder to deal with. One approach is to say: “I know you are not concerned, but I am concerned and I wonder if you would see a doctor to ease my worries?” Also explaining that memory problems can at least to some extent have reversible causes means a visit to the doctor to at least rule these out is an important step. It may also be encouraging to say to the person: “If there is something with your memory that will get worse over time, would you want to know?” (Most people <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2408568/">answer yes</a> to this). <h2>Seeing a GP</h2> If your partner agrees to visit a GP, it is helpful to prepare by filling in a diary for a week with the kind of memory (or other) problems experienced, what was happening at the time and the effect of the memory failure. This can be shared with a GP to help them to understand the issues. When people hear even the suggestion of the word dementia, they are faced with the uncertainties of what will become of them, of what they will lose, what they can keep up and where they will end up. These uncertainties are often shared with family members. But research shows that positive aspects of timely diagnosis <a href="https://www.scie.org.uk/dementia/symptoms/diagnosis/early-diagnosis.asp">outweigh fears</a> over time. At the same time, there are often ongoing stresses to do with memory impairments or confusion. With these stresses, everyday life can be troublesome, family relationships can suffer, and people can find it difficult to be supportive of each other. Being honest and open is the best policy. Stating that we are in this together, I want to help, let’s meet whatever happens head on, can help. If a person becomes resistant, it may be there is another family member who might better assist the person.<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/219172/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/kate-irving-1493654">Kate Irving</a>, Professor of Clinical Nursing, <a href="https://theconversation.com/institutions/dublin-city-university-1528">Dublin City University</a> Image credits: Getty Images 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/more-than-a-third-of-people-with-dementia-dont-know-they-have-it-what-to-do-if-you-suspect-your-partner-has-the-condition-219172">original article</a>.

Mind

8 reasons everyone should know their blood type

Why you should know your blood type What’s in a blood type? Potentially a lot, according to research, including a review of studies published in the Wiley Interdisciplinary Reviews: Systems Biology and Medicine, that connects different blood groups to everything from risk of heart disease and dementia to urinary tract infections and the norovirus. While none of the studies are conclusive about cause and effect (they can’t say X blood type causes Y disease) and any increased risks are still pretty small, the research does highlight the importance of knowing your type – A, B, AB, or O – and how it could affect your wellbeing. Blood clots: Type AB, A, and B increases risk Danish researchers studied how blood type interacts with a genetic predisposition for deep-vein thrombosis (DVT), or blood clots in the lower legs that can travel to the lungs and become life-threatening. After analysing data on about 66,000 people over more than 30 years, they found that those with type AB, A, or B had a 40 per cent higher risk of DVT than people with type O, the most common type. When the scientists did further analysis to see which factors have the biggest impact on DVT risk on a population level, they found that an AB blood type contributed to about 20 per cent of blood clots; genetic mutations accounted for 11 per cent, being overweight accounted for 16 per cent, and smoking accounted for six per cent. Heart disease: Type AB, B, and A all increase risk People whose blood type is A, B, or AB have an increased risk of heart disease and shorter life spans than people who have type O blood, according to a large study published in BMC Medicine. After following more than 50,000 middle-age and elderly people for seven years, on average, researchers found that as many as nine per cent of cardiovascular deaths were attributed to having non-O blood types. However, as any doctor will tell you, lifestyle factors like weight, smoking and diet, which, unlike blood type, are modifiable, have a much greater impact on heart disease. Stomach cancer: Types A and AB increases risk Researchers have known for a while that people with blood type A are at risk for stomach cancer. But research published in BMC Cancer shows that people with blood type AB are also at risk. Using genetic data from a large number of cases and controls, researchers found a link between both blood types and gastric cancer in Chinese populations. A review of 39 previous studies confirmed their findings. Fertility: Type O reduces it Women with this blood type were twice as likely to have blood levels of the hormone FSH high enough to indicate low ovarian reserve, a measure of fertility, according to a study published in Human Reproduction. Researchers couldn’t say for sure why, though. Given that type O blood is the most prevalent, it doesn’t pay to worry too much about it. Age is a far more important risk factor for fertility problems. Pregnancy risks This has nothing to do with your “letter” blood type or the type determined by the ABO grouping system. This has to do with what’s known as the Rhesus (Rh) factor, which determines whether your blood type is positive or negative. This could cause complications in pregnant women if the baby’s Rh blood type is different from the mother’s. For instance, if the mother has a negative blood type and the baby has a positive one, the mother’s body can actually build up antibodies against the baby’s blood type. Luckily, this doesn’t affect the baby, but it could have a negative effect on future pregnancies. Fortunately, doctors can give pregnant women a shot early in their pregnancy that can prevent Rh-incompatibility problems. Dementia and memory loss: Type AB increases risk People with type AB blood have an 82 per cent greater risk for cognitive decline later in life, according to a study published in Neurology. That’s likely because they have larger amounts of what’s known as the Factor VIII protein, which helps with blood clotting. Study participants with higher levels of this protein were 24 per cent more likely to develop memory problems – regardless of their blood type – than people with lower levels. Blood type, however, is far from the only, or even most important, factor that affects your risk for cognitive decline. Stroke: Type O has the lowest risk People with a blood type other than O (the most common) have a higher risk of cardiovascular issues such as stroke, according to a study published in the Journal of Thrombosis and Haemostasis. Biologists are still investigating why this might be; one possible explanation is that non-O blood types contain more of the Von Willebrand factor, a protein that has been connected to blood clotting and stroke in the past. Mosquitos like Type O blood If you find yourself scratching bug bites all summer long, your blood type might be to blame. In a one small study, researchers found that type Os are up to twice as attractive to mosquitoes as type As, with type Bs falling somewhere in the middle. Image credits: Shutterstock This article originally appeared on <a href="https://www.readersdigest.com.au/healthsmart/8-reasons-everyone-should-know-their-blood-type" target="_blank" rel="noopener">Reader's Digest</a>.

Body

Name that rash: 6 common skin conditions (and how to treat them)

Psoriasis What psoriasis is like: Psoriasis is made of red, scaly plaques that can be itchy and painful. It can show up anywhere but is most commonly found on the scalp, as well as the outside of the elbows and knees. It usually starts between age 10 and 30 and tends to be a chronic condition. “It’s a stubborn disease that waxes and wanes, so people have it for their whole lives,” says dermatologist Paul Cohen. What causes psoriasis: This skin rash is the result of your immune system attacking the skin’s cells, and creating new ones too quickly, which then build up into the plaques. There’s no one single cause, but the condition runs in families. Stress, obesity, smoking and having many infections (particularly strep throat) increase your risk. How to treat psoriasis: The first step is generally topical steroids, which can be used for a week or two at a time to clear up the plaques. For ongoing treatment, people use a synthetic form of vitamin D (which slows skin growth), medicated shampoos and retinoids (a topical version of vitamin A). Daily exposure to sunlight also seems to help, as does moisturising well. For more serious cases, options include oral medications that suppress the immune system and phototherapy done in a doctor’s office with a special light. (Discover more applications of light therapy.) Possible red flag: Serious cases can involve the joints, a condition called psoriatic arthritis. Also, psoriasis increases your chances of having some other diseases, including type 2 diabetes, cardiovascular disease and autoimmune conditions such as Crohn’s – all of which are, like psoriasis, linked to inflammation. Hives What hives are like: Hives are itchy, raised welts that often have a red ring around them. Their most salient characteristic is that they disappear after about a day, only to show up later in a different location. They come in two forms: acute, which lasts six weeks or less, and chronic. What causes hives: Hives are often the result of the body releasing histamine as part of an allergic reaction to drugs, food or some other irritant. They also commonly appear after a viral illness, as a side effect of your immune system revving up to battle the disease. “There are a number of potential triggers,” says dermatologist Katie Beleznay. In most cases, she adds, the specific origin is never determined. How to treat hives: Since hives are a histamine reaction, over-the-counter antihistamines are the first line of defence. If that doesn’t clear them up, ask a doctor if you should use a stronger antihistamine or oral prednisone, an anti-inflammatory medication. Possible red flag: Rarely, people suffer from ongoing outbreaks of hives almost daily for six weeks or more, a condition called chronic idiopathic urticaria (CIU). The treatment for CIU is the same as for regular hives, but in some cases, it can also be a sign of an underlying thyroid disease or cancer. Eczema What eczema is like: Eczema presents as patches of red, scaly skin that are extremely itchy, especially at night. These rashes often appear on the inside of your elbows and knees. If it’s more serious, the skin might blister or look thickened and white in those areas. What causes eczema: Eczema is the result of having a weakened skin barrier, which can lead to inflammation and an overreaction from your immune system. Most people are born with it, and your genes are partly to blame. “You’re more predisposed to eczema if you have a family history of asthma, hay fever or the condition itself,” says Lisa Kellett, a dermatologist in Toronto. Some research also suggests that it might be a reaction to pollution, or to not being exposed to enough germs in childhood. (Kids who have dogs, for example, are less likely to have eczema.) How to treat eczema: For general maintenance, apply a thick, hypoallergenic moisturizer to affected areas immediately after a bath or shower and at night. More serious flares will need topical prescription steroid creams or non-steroid immunosuppressant creams. People with stubborn eczema might also try phototherapy, which uses UVB light to help calm your immune system and reduce itchiness. Possible red flag: Rarely, what looks like eczema is actually skin cancer, as both can appear red and scaly. “The difference with skin cancer is that it doesn’t go away if you use a steroid,” says Kellett. Contact Dermatitis What contact dermatitis is like: Contact dermatitis is a variation of eczema, and it looks similar – red, itchy patches on your skin. But unlike that chronic condition, this skin rash is a reaction to something specific and appears only where the offending object has made contact. “Poison ivy, for instance, will show up as a streak where the branch touched the skin,” says Beleznay. What causes contact dermatitis: Besides poison ivy, other common culprits that can cause the immune system to go into overdrive are face cream, jewellery or fragrances. You can also develop a new intolerance to something you’ve used for a long time, such as Polysporin. If it’s not clear what caused it, your dermatologist can do a patch test, putting small amounts of suspected substances on your skin to see if you react. How to treat contact dermatitis: Contact dermatitis is treated with topical steroids, or a stronger oral one, to calm down your immune system and stop the reaction. Possible red flag: Like eczema, the red and scaly presentation of contact dermatitis could be confused for skin cancer, which is another reason to visit your doctor if you’re not sure what caused it. Rosacea What rosacea is like: As rosacea is a dilation of the blood vessels in your cheeks and nose, it often presents as red, sensitive skin in those places. Another form of the condition also includes bumps that resemble acne. For some people, the skin on their nose thickens, making it appear larger. What causes rosacea: We don’t know what brings rosacea on, but, as with eczema, you’re more likely to have it if others in your family do, too. You’re also prone to acquire the condition if you have sun-damaged skin. “Rosacea usually begins around the age of 35 and gets worse with time,” says Kellett. People often find their flare-ups come after eating or drinking specific things. How to treat rosacea: For many, preventing activation of their rosacea is as simple as avoiding triggers – but that’s easier than it sounds and can be a serious test of a sufferer’s willpower. “Those are often the good things in life,” says Beleznay, citing coffee, spicy foods and alcohol as common aggravators. Some women find that everyday makeup is enough to cover up the cosmetic impact of the condition, while others use prescription creams or laser or light therapy to constrict the blood vessels in the cheeks and reduce redness. For those whose rosacea includes bumps, topical creams or oral antibiotics often get rid of them. Possible red flag: Rarely, what looks like rosacea can be confused for the butterfly rash that’s a symptom of lupus, a serious autoimmune disease. The butterfly rash is named as such because of the shape it makes on the nose and both cheeks. Shingles What shingles is like: Shingles normally starts out as a tingly, numb or bruised feeling in a small area, most commonly a patch on the abdomen. A few days later, a painful skin rash with blisters appears over those places. As the condition follows the path of a nerve, the rash eventually presents as a stripe that lasts from two to six weeks. What causes shingles: This one’s easy: chicken pox. Even once you have fully recovered from that virus, your body never totally beats it; it simply retreats and lies dormant in your nerve cells, where, decades later, it can re-erupt as shingles. You’re more likely to get them if you’re immunocompromised or over 50, the age at which most public health agencies recommend you get the vaccine. How to treat shingles: If you suspect you have shingles, see your doctor immediately. “You have to go right away because studies show that people do much better if the antiviral pills are started within 72 hours of the rash onset,” says Cohen. Additionally, sufferers are often given medication, like a local anaesthetic or codeine, to help control the pain. Possible red flag: The real worry with shingles is that for some people, if it is not contained quickly, the virus can lead to longer-term pain lasting over three months and in some cases over a year. If the skin rash appears on the face, it can even cause blindness. Image credits: Getty Images This article originally appeared on <a href="https://www.readersdigest.com.au/healthsmart/name-that-rash-6-common-skin-conditions-and-how-to-treat-them" target="_blank" rel="noopener">Reader's Digest</a>.

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3 ways to prepare for bushfire season if you have asthma or another lung condition

<a href="https://theconversation.com/profiles/kazi-mizanur-rahman-1057615">Kazi Mizanur Rahman</a>, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a>; <a href="https://theconversation.com/profiles/joe-duncan-1472949">Joe Duncan</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/jo-longman-1221029">Jo Longman</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Australia’s bushfire season is officially <a href="https://www.nsw.gov.au/media-releases/fire-season-commences">under way</a> during an <a href="https://www.climatecouncil.org.au/resources/what-the-return-of-el-nino-means/">El Niño</a>. And after three wet years, and the <a href="https://www.afac.com.au/auxiliary/publications/newsletter/article/seasonal-bushfire-outlook-spring-2023#:%7E:text=For%20spring%202023%2C%20increased%20risk,bushfire%20this%20season%20are%20widespread">plant growth</a> that comes with it, there’s fuel to burn. With the prospect of <a href="https://theconversation.com/its-official-australia-is-set-for-a-hot-dry-el-nino-heres-what-that-means-for-our-flammable-continent-209126">catastrophic bushfire</a> comes smoke. This not only affects people in bushfire regions, but those <a href="https://theconversation.com/bushfire-smoke-is-everywhere-in-our-cities-heres-exactly-what-you-are-inhaling-129772">in cities and towns</a> far away, as smoke travels. People with a <a href="https://www.atsjournals.org/doi/10.1164/rccm.202012-4471LE">lung condition</a> are among those especially affected. <h2>What’s so dangerous about bushfire smoke?</h2> Bushfire smoke <a href="https://www.health.nsw.gov.au/environment/air/Pages/common-air-pollutants.aspx">pollutes the air</a> we breathe by increasing the concentration of particulate matter (or PM). Once inhaled, <a href="https://www.health.nsw.gov.au/environment/air/Pages/particulate-matter.aspx">small particles</a> (especially with a diameter of 2.5 micrometres or less, known as PM2.5) can get deep into the lungs and into the bloodstream. Concentration of gases in the air – such as <a href="https://www.health.nsw.gov.au/environment/air/Pages/ozone.aspx">ozone</a>, <a href="https://www.health.nsw.gov.au/environment/air/Pages/nitrogen-dioxide.aspx">nitrogen dioxide</a> and <a href="https://www.health.nsw.gov.au/environment/air/Pages/sulphur-dioxide.aspx">sulfur dioxide</a> – also increase, to pollute the air. All these cause the airway to <a href="https://www.alfredhealth.org.au/news/the-effects-of-bushfire-smoke-explained/">narrow and spasm</a>, making it hard to breathe. This can be even worse for people with existing asthma or other respiratory conditions whose airways are already inflamed. Emergency department visits and hospital admissions for asthma-related symptoms <a href="https://www.sciencedirect.com/science/article/pii/S0013935119305742?dgcid=author">rise</a> <a href="https://pubmed.ncbi.nlm.nih.gov/33601224/">after exposure</a> to bushfire smoke. Smoke from the bushfires in summer 2019/20 <a href="https://www.mja.com.au/system/files/issues/213_06/mja250545.pdf">resulted in</a> an estimated 400 deaths or more from any cause, more than 1,300 emergency department visits for asthma symptoms, and more than 2,000 hospital admissions for respiratory issues. Even if symptoms are not serious enough to warrant emergency medical attention, exposure to bushfire smoke <a href="https://www.qld.gov.au/health/staying-healthy/environmental/after-a-disaster/bushfires/bushfire-smoke-and-your-health#:%7E:text=Signs%20of%20smoke%20irritation%20include,throat%2C%20runny%20nose%20and%20coughing">can lead to</a> cough, nasal congestion, wheezing and asthma flares. If you have <a href="https://theconversation.com/what-causes-asthma-what-we-know-dont-know-and-suspect-96409">asthma</a>, <a href="https://theconversation.com/explainer-what-is-chronic-obstructive-pulmonary-disease-25539">chronic obstructive pulmonary disease</a>, <a href="https://www.nhlbi.nih.gov/health/bronchiectasis#:%7E:text=Bronchiectasis%20is%20a%20condition%20that,These%20tubes%20are%20called%20airways.">bronchiectasis</a> or another lung condition, or you care for someone who has, here’s what you can do to prepare for the season ahead. <h2>1. Avoid smoke</h2> Monitor your local air quality by downloading one or both of these apps: <ul> <li> <a href="https://asthma.org.au/what-we-do/current-projects/airsmart/">AirSmart</a> from Asthma Australia has live air-quality information to help you plan and act </li> <li> <a href="https://airrater.org/">AirRater</a>, developed by Australian scientists, can be another useful app to monitor your environment, track your symptoms and help manage your health. </li> </ul> During times of poor air quality and smoke stay indoors and avoid smoke exposure. Close windows and doors, and if you have one, use an air conditioner to recirculate the air. Avoid unnecessary <a href="https://28bysamwood.com/blog/fitness/should-you-exercise-if-its-smoky-outside/">physical activity</a> which makes us breathe more to deliver more oxygen to the body, but also means we inhale more polluted air. Consider temporarily moving to a safer residence. Well-fitting N95/P2 masks can reduce your exposure to fine smoke particles if you must travel. However they can make it more difficult to breathe if you are unwell. In that case, you may find a mask with a valve <a href="https://theconversation.com/how-to-protect-yourself-against-bushfire-smoke-this-summer-154720">more comfortable</a>. <h2>2. Have an action plan</h2> Taking your regular preventer medication ensures your lung health is optimised before the danger period. Ensure you have a <a href="https://www.nationalasthma.org.au/health-professionals/asthma-action-plans">written action plan</a>. This provides you with clear instructions on how to take early actions to prevent symptoms deteriorating or to reduce the severity of flare-ups. Review this plan with your GP, share it with a family member, pin it to the fridge. Make sure you have emergency medication available, know when to call for help, and what medication to take while you wait. You may consider storing an emergency “reliever puffer” in your home or with a neighbour. <h2>3. Have the right equipment</h2> High-efficiency particulate air (HEPA) filters <a href="https://www.phrp.com.au/issues/online-early/residential-indoor-air-quality-and-hepa-cleaner-use/">can reduce</a> smoke exposure inside the home during a fire event by 30-74%. These filters remove particulate matter from the air. A spacer, which is a small chamber to contain inhaled medication, can help you take emergency medication if you are breathing quickly. You may want to have one to hand.<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/214065/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/kazi-mizanur-rahman-1057615">Kazi Mizanur Rahman</a>, Associate Professor of Healthcare Innovations, Faculty of Health Sciences and Medicine, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a>; <a href="https://theconversation.com/profiles/joe-duncan-1472949">Joe Duncan</a>, Clinical Associate Lecturer, Northern Clinical School and Lecturer, Internal Medicine. Rural Clinical School (Northern Rivers), <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/jo-longman-1221029">Jo Longman</a>, Senior Research Fellow, The University Centre for Rural Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: Getty Images 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/3-ways-to-prepare-for-bushfire-season-if-you-have-asthma-or-another-lung-condition-214065">original article</a>.

Body

What your family history says about your eyesight

Eye disorders can be caused by many things such as infection and injury but did you know it can also be genetic? We know looking up our family history is important for our health but it’s also vitally important to do so for our eyes. Genetics do play a role in determining your family’s susceptibility to certain eye diseases so it’s a good idea to check your family history as well as record any eye issues you have for future generations. Here are some of the most common hereditary eye conditions. Glaucoma Not all glaucoma is inherited but the most common type, primary open-angle glaucoma, is hereditary. According to the Glaucoma Research Foundation, a family history of glaucoma increases your risk around four to nine times. Coupled with the fact glaucoma is much more common as you age, it’s a good idea to get your eyes checked regularly. Glaucoma can lead to the reduction in peripheral vision and even blindness. Signs include bulging eyes, excessive tearing and abnormal sensitivity to light. Age-related macular degeneration Scientist have found that genetics may contribute to the risk of having macular degeneration but it’s not always the case. Some people never develop it even though both parents may have it while others get it even though there is no family history. The current research shows that genetics contribute to macular degeneration anywhere from 40 to 70 percent. However, whether you have a family history or not it’s important to get your eyes checked as age-related macular degeneration is the leading cause of vision loss in people aged 50 and over. Colour blindness A misnomer as people are not ‘blind’ but colour vision deficient. People who are colour blind usually cannot distinguish between certain colours such as red and green. Inherited colour blindness is common in men with women rarely affected. There is no treatment and most people adjust to the condition. Retinitis pigmentosa A mutated gene causes the retina to degenerate which can lead to night blindness and vision loss. Most cases are inherited and it usually appears in childhood but vision loss doesn’t occur until later in life. There is unfortunately no cure and no treatments but researchers are making significant progress in identifying the genes that cause retinitis pigmentosa. Achromatopsia An inherited condition (only if both parents have the recessive gene) that affects 1 in 33,000 people. The condition is associated with decreased vision, sensitivity to light and colour blindness. Optic atrophy Optic atrophy may be inherited or caused by brain trauma, inflammation, degenerative disorders, haemorrhage or tumour. The breakdown of the optic nerve causes vision loss. Image credits: Getty Images

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