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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

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

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

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

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

Drinking alcohol this Christmas and New Year? These medicines really don’t mix

<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> and <a href="https://theconversation.com/profiles/jessica-pace-1401278">Jessica Pace</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> A glass or two of champagne with Christmas lunch. A cool crisp beer at the beach. Some cheeky cocktails with friends to see in the New Year. There seem to be so many occasions to unwind with an alcoholic drink this summer. But if you’re taking certain medications while drinking alcohol, this can affect your body in a number of ways. Drinking alcohol with some medicines means they may not work so well. With others, you risk a life-threatening overdose. Here’s what you need to know if you’re taking medication over summer and plan to drink. <h2>Why is this a big deal?</h2> After you take a medicine, it travels to the stomach. From there, your body shuttles it to the liver where the drug is metabolised and broken down before it goes into your blood stream. Every medicine you take is provided at a dose that takes into account the amount of metabolism that occurs in the liver. When you drink alcohol, this is also broken down in the liver, and it can affect how much of the drug is metabolised. Some medicines are metabolised more, which can mean not enough reaches your blood stream to be effective. Some medicines are metabolised less. This means you get a much higher dose than intended, which could lead to an overdose. The effects of alcohol (such as sleepiness) can act in addition to similar effects of a medicine. Whether or not you will have an interaction, and what interaction you have, depends on many factors. These include the medicine you are taking, the dose, how much alcohol you drink, your age, genes, sex and overall health. Women, older people and people with liver issues are more likely to have a drug interaction with alcohol. <h2>Which medicines don’t mix well with alcohol?</h2> Many medicines interact with alcohol regardless of whether they are prescribed by your doctor or bought over the counter, such as <a href="https://www.drugs.com/article/herbal-supplements-alcohol.html">herbal medicines</a>. 1. Medicines + alcohol = drowsiness, coma, death Drinking alcohol and taking a medicine that depresses the <a href="https://adf.org.au/drug-facts/depressants/">central nervous system</a> to reduce arousal and stimulation can have additive effects. Together, these can make you extra drowsy, slow your breathing and heart rate and, in extreme cases, lead to coma and death. These effects are more likely if you use more than one of this type of medicine. Medicines to look out for include those for depression, anxiety, schizophrenia, pain (except <a href="https://www.nps.org.au/australian-prescriber/articles/alcohol-and-paracetamol">paracetamol</a>), sleep disturbances (such as insomnia), allergies, and colds and flu. It’s best not to drink alcohol with these medicines, or to keep your alcohol intake to a minimum. 2. Medicines + alcohol = more effects Mixing alcohol with some medicines increases the effect of those medicines. One example is with the sleeping tablet zolpidem, which is <a href="https://www.tga.gov.au/news/product-recalls/zolpidem-stilnox">not to be taken with alcohol</a>. Rare, but serious, side effects are strange behaviour while asleep, such as sleep-eating, sleep-driving or sleep-walking, which are more likely with alcohol. 3. Medicines + craft beer or home brew = high blood pressure Some types of medicines only interact with some types of alcohol. Examples include some medicines for depression, such as phenelzine, tranylcypromine and moclobemide, the antibiotic linezolid, the Parkinson’s drug selegiline, and the cancer drug procarbazine. These so-called <a href="https://www.mydr.com.au/medicine/monoamine-oxidase-inhibitors-maois-for-depression/">monoamine oxidase inhibitors</a> <a href="https://www.health.qld.gov.au/__data/assets/pdf_file/0020/145802/oncol_maoi.pdf">only interact with</a> some types of boutique and artisan beers, beers with visible sediment, Belgian, Korean, European and African beers, and home-made beers and wine. These types of alcohol contain high levels of tyramine, a naturally occurring substance usually broken down by your body that doesn’t ordinarily cause any harm. However, monoamine oxidase inhibitors prevent your body from breaking down tyramine. This increases levels in your body and can cause your blood pressure to rise to dangerous levels. 4. Medicines + alcohol = effects even after you stop drinking Other medicines interact because they affect the way your body breaks down alcohol. If you drink alcohol while using such medicines you may you feel nauseous, vomit, become flushed in the face and neck, feel breathless or dizzy, your heart may beat faster than usual, or your blood pressure may drop. This can occur even after you stop treatment, then drink alcohol. For example, if you are taking metronidazole you should avoid alcohol both while using the medicine and for at least 24 hours after you stop taking it. An example of where alcohol changes the amount of the medicine or related substances in the body is acitretin. This medication is used to treat skin conditions such as severe psoriasis and to prevent skin cancer in people who have had an organ transplant. When you take acitretin, it changes into another substance – <a href="https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent&id=CP-2017-CMI-02034-1&d=20221221172310101">etretinate</a> – before it is removed from your body. Alcohol increases the amount of etretinate in your body. This is especially important as etretinate can cause birth defects. To prevent this, if you are a woman of child-bearing age you should avoid alcohol while using the medicine and for two months after you stop taking it. <h2>Myths about alcohol and medicines</h2> Alcohol and birth control One of the most common myths about medicines and alcohol is that you can’t drink while using <a href="https://youly.com.au/blog/sexual-reproductive-health/does-alcohol-make-the-pill-less-effective/">the contraceptive pill</a>. It is generally safe to use alcohol with the pill as it <a href="https://www.healthline.com/health/womens-health/birth-control-and-alcohol#:%7E:text=There's%20a%20bit%20of%20good,a%20less%20effective%20birth%20control.">doesn’t directly affect</a> how well birth control works. But the pill is most effective when taken at the same time each day. If you’re drinking heavily, you’re more likely to forget to do this the next day. Alcohol can also make some people nauseous and vomit. If you vomit within three hours of taking the pill, it will not work. This increases your risk of pregnancy. Contraceptive pills can also affect your response to alcohol as the hormones they contain can change the way your body <a href="https://americanaddictioncenters.org/alcoholism-treatment/birth-control">removes alcohol</a>. This means you can get drunk faster, and stay drunk for longer, than you normally would. Alcohol and antibiotics Then there’s the myth about not mixing alcohol with any <a href="https://theconversation.com/mondays-medical-myth-you-cant-mix-antibiotics-with-alcohol-4407">antibiotics</a>. This only applies to <a href="https://www.healthdirect.gov.au/medicines/medicinal-product/aht,21161/metronidazole">metronidazole</a> and <a href="https://www.healthdirect.gov.au/medicines/brand/amt,1011571000168100/linezolid-apo">linezolid</a>. Otherwise, it is generally safe to use alcohol with antibiotics, as alcohol does not affect how well they work. But if you can, it is best to avoid alcohol while taking antibiotics. Antibiotics and alcohol have similar side effects, such as an upset stomach, dizziness and drowsiness. Using the two together means you are more likely to have these side effects. Alcohol can also reduce your energy and increase how long it takes for you to recover. <h2>Where can I go for advice?</h2> If you plan on drinking alcohol these holidays and are concerned about any interaction with your medicines, don’t just stop taking your medicines. Your pharmacist can advise you on whether it is safe for you to drink based on the medicines you are taking, and if not, provide advice on alternatives.<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/196646/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 Sydney Pharmacy School, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/jessica-pace-1401278">Jessica Pace</a>, Associate Lecturer, <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/drinking-alcohol-this-christmas-and-new-year-these-medicines-really-dont-mix-196646">original article</a>.

Caring

"Get the medic": Grant Denyer collapses in first-look trailer for Amazing Race

The Amazing Race Australia is back and more dramatic than ever, after Gold Logie winner Grant Denyer collapsed on set, needing medical attention. The first-look teaser of the celebrity edition of the reality show has come out, and showcased some of the most tense scenes of the season. The 45-year-old Logie winner is at the centre of the scene, as footage showed him lying on the ground as paramedics struggle to give him urgent medical attention, while his wife Chezzi watches on. “Can we get the medic? He’s shaking, he’s shivering,” a voice said. The upcoming season of the show will feature stars Grant Denyer and his wife, Jackie Gillies and husband Ben, Bec Judd and sister Kate Twigley, and Australian Survivor player "King" George and sister Pam. A few of the other stars competing this season are The Voice Australia co-host Darren McMullen and his nephew Tristan, Kath and Kim comedian Peter Rowsthorn and his daughter, and Too Hot To Handle stars Harry and Teddy. The show is set to air in October on Ten, and the stars will work with their loved ones to compete for $100,000 to their chosen charity, as they race against the clock to complete challenges in countries including India, Cambodia, Malaysia and Borneo. Image: Ten

Medical Research Future Fund has $20 billion to spend. Here’s how we prioritise who gets what

<a href="https://theconversation.com/profiles/adrian-barnett-853">Adrian Barnett</a>, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</a> and <a href="https://theconversation.com/profiles/philip-clarke-1149967">Philip Clarke</a>, <a href="https://theconversation.com/institutions/university-of-oxford-1260">University of Oxford</a> The <a href="https://www.health.gov.au/our-work/medical-research-future-fund">Medical Research Future Fund</a> (MRFF) is a A$20 billion fund to support Australian health and medical research. It was set up in 2015 to deliver practical benefits from medical research and innovation to as many Australians as possible. Unlike the other research funding agencies, such the National Health and Medical Research Council (NHMRC), most of the MRFF funding is priority-driven. It seeks to fund research in particular areas or topics rather than using open calls when researchers propose their own ideas for funding. As the <a href="https://www.smh.com.au/politics/federal/not-how-you-run-a-1b-scheme-science-fund-backers-lead-chorus-for-reform-20230619-p5dhni.html">Nine newspapers</a> outlined this week, researchers have criticised the previous Coalition government’s allocation of MRFF funds. There is widespread consensus the former health minister had <a href="https://www.theage.com.au/politics/federal/a-centre-never-built-and-a-hospital-that-missed-out-the-coalition-s-unusual-20b-research-fund-20230619-p5dhng.html">too much influence</a> in the allocation of funds, and there was limited and sometimes no competition when funding was directly allocated to one research group. The current Health Minister, Mark Butler, has instituted a <a href="https://www.innovationaus.com/billion-dollar-medical-research-grants-process-under-review/">review</a>. So how should the big decisions about how to spend the MRFF be made in the future to maximise its value and achieve its aims? <h2>Assess gaps in evidence</h2> Research priorities for the MRFF are set by the <a href="https://www.health.gov.au/committees-and-groups/australian-medical-research-advisory-board-amrab?language=und">Australian Medical Research Advisory Board</a>, which widely consults with the research sector. However, most researchers and institutions will simply argue more funding is needed for their own research. If the board seeks to satisfy such lobbying, it will produce fragmented funding that aligns poorly with the health needs of Australians. A better approach would be to systematically assemble evidence about what is known and the key evidence gaps. Here, the board would benefit from what is known as a “<a href="https://pubmed.ncbi.nlm.nih.gov/15484602/">value of information</a>” framework for decision-making. This framework systematically attempts to quantify the most valuable information that will reduce the uncertainty for health and medical decision-making. In other words, it would pinpoint which information we need to allow us to better make health and medical decisions. There have been <a href="https://pubmed.ncbi.nlm.nih.gov/30288400/">attempts</a> to use this method in Australia to help inform how we prioritise hospital-based research. However, we now need to apply such an approach more broadly. <h2>Seek public input</h2> A structured framework for engaging with the public is also missing in Australia. The public’s perspective on research prioritisation has often been overlooked, but as the ultimate consumers of research, they need to be heard. Research is a highly complex and specialised endeavour, so we can’t expect the public to create sensible priorities alone. One approach used overseas has been developed by the <a href="https://www.jla.nihr.ac.uk/">James Lind Alliance</a>, a group in the United Kingdom that combines the public’s views with researchers to create agreed-on priorities for research. This is done using an intensive process of question setting and discussion. Priorities are checked for feasibility and novelty, so there is no funding for research that’s impossible or already done. The priorities from the James Lind Alliance process can be surprising. The top priority in the area of <a href="https://www.jla.nihr.ac.uk/priority-setting-partnerships/irritable-bowel-syndrome/top-10-priorities.htm">irritable bowel syndrome</a>, for example, is to discover if it’s one condition or many, while the second priority is to work on bowel urgency (a sudden urgent need to go to the toilet). While such everyday questions can struggle to get funding in traditional systems that often focus on novelty, funding research in these two priority areas could lead to the most benefits for people with irritable bowel syndrome. <h2>Consider our comparative advantages</h2> Australia is a relatively small player globally. To date, the MRFF has allocated around <a href="https://www.health.gov.au/resources/publications/medical-research-future-fund-mrff-grant-recipients?language=und">$2.6 billion</a>, just over 5% of what the United States allocates through the National Institute of Health funding in a <a href="https://www.who.int/observatories/global-observatory-on-health-research-and-development/monitoring/investments-on-grants-for-biomedical-research-by-funder-type-of-grant-health-category-and-recipient">single year</a>. A single research grant, even if it involves a few million dollars of funding, is unlikely to lead to a medical breakthrough. Instead, the MRFF should prioritise areas where Australia has a comparative advantage. This could involve building on past success (such as the research that led to the HPV, or human papillomavirus, vaccine to prevent cervical cancer), or where Australian researchers can play a critical role globally. However, there is an area where Australian researchers have an absolute advantage: using research to improve our own health system. A prime example would be finding ways to improve dental care access in Australia. For example, a randomised trial of different ways of providing insurance and dental services, similar to the <a href="https://www.rand.org/health-care/projects/hie.html">RAND Health Insurance Experiment</a> conducted in the United States in the 1970s. This could provide the evidence needed to design a sustainable dental scheme to complement Medicare. Now that is something the MRFF should consider as a funding priority.<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/209977/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/adrian-barnett-853">Adrian Barnett</a>, Professor of Statistics, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</a> and <a href="https://theconversation.com/profiles/philip-clarke-1149967">Philip Clarke</a>, Professor of Health Economics, <a href="https://theconversation.com/institutions/university-of-oxford-1260">University of Oxford</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/medical-research-future-fund-has-20-billion-to-spend-heres-how-we-prioritise-who-gets-what-209977">original article</a>.

Money & Banking

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

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

Caring

9 medical reasons your short-term memory is getting worse

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

Mind

Which medicines don’t go well with flying?

Every day, <a href="http://www.iata.org/pressroom/pr/Pages/2012-12-06-01.aspx">more than 10 million people</a> take a flight somewhere in the world. While flying is relatively safe, the unique environmental conditions can put passengers at risk if they’re taking certain medications. These include any hormone-based drugs, like the contraceptive pill and some fertility medicines, and drugs used to prevent heart attack and stroke. Antihistamines should also not be used to help passengers sleep during a flight. <h2>What makes flying different from other forms of travel?</h2> While flying is <a href="https://theconversation.com/whats-most-likely-to-kill-you-measuring-how-deadly-our-daily-activities-are-72505">one of the safest forms of travel</a>, there are specific risks that come with air travel, regardless of the length of the flight. Passenger planes are typically pressurised to the same atmospheric conditions that are found at 10,000 feet altitude. <a href="https://www.ncbi.nlm.nih.gov/pubmed/6823572">At that level</a>, <a href="https://www.higherpeak.com/altitudechart.html">the effective oxygen level is only 14.3%</a>, which is much lower than the 20.9% found at ground level. An additional risk is reduced blood flow from a lack of movement and sitting in cramped conditions, unless of course you’re fortunate enough to be in business or first class. And finally, dehydration is also a common side effect of flying due to the lack of humidity in the air. When these conditions are combined, it results in an increased risk of <a href="https://www.healthdirect.gov.au/deep-vein-thrombosis">deep vein thrombosis</a>, which is also known as DVT. This is a type of blood clot that occurs in the veins deep in the body and occurs most often in the legs. The development of a blood clot can result in blocked blood flow to the lungs, heart, or brain, which in turn can cause a heart attack or stroke. <h2>Contraceptive pill and other hormone-based medicines</h2> Given the inherent risk of a blood clot when flying, a passenger should use with caution any medication that can further increase the risk of a clot. Some brands of contraceptive for women (tablet or implant formulation) are <a href="http://www.theaustralian.com.au/national-affairs/health/new-bloodclot-alerts-added-to-diane35-eds-product-information/news-story/eaa0b596541a760e9c6cf89b37900c42">known to increase the chances of a blood clot</a>, although the overall increase in risk is small. While it’s thought the major risk comes from the hormone <a href="http://www.healthywomen.org/condition/estrogen">estrogen</a>, <a href="http://www.cochrane.org/CD010813/FERTILREG_contraceptive-pills-and-venous-thrombosis">a review of all the medical evidence in 2014</a> showed there’s a risk of blood clot from all contraceptive medicines. Likewise, <a href="https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/hormone-replacement-therapy-hrt-and-menopause">hormone replacement therapy</a>, particularly those that include estrogen, or some fertility medicines, such as <a href="https://www.babycenter.com/0_fertility-drug-gonadotropins_6188.bc">gonadotrophins</a>, can increase the risk of a blood clot. If you take one of these medicines, it does not mean you cannot fly, nor that you should necessarily stop taking the drug. Many millions of women fly while taking these medicines and suffer no ill effects. But the risk is also increased if you have an underlying health condition that includes type II diabetes, heart disease, and prior heart attacks or strokes. As such, passengers who also take medications to help prevent heart attacks and strokes should consult their doctor or pharmacist before flying. If you’re at increased risk of a blood clot, then an anti-platelet medication may be suitable for you. These medicines act by stopping the blood cells from sticking together and include prescription medicines such as <a href="http://www.melbournehaematology.com.au/fact-sheets/warfarin.html">warfarin</a> and <a href="https://www.nps.org.au/australian-prescriber/articles/clopidogrel">clopidogrel</a>, and over-the-counter medicines such as <a href="https://www.healthdirect.gov.au/medicines/brand/amt,34661000168102/aspirin-low-dose-pharmacy-action">low dose aspirin</a>. <h2>Antihistamines</h2> Many passengers can have trouble sleeping when flying, especially on long-haul flights. Parents flying with young children can also be concerned about them not sleeping or being unsettled and annoying other passengers. In these instances, many will turn to <a href="https://www.healthdirect.gov.au/antihistamines">sedating antihistamines</a>, like <a href="https://www.healthdirect.gov.au/medicines/brand/amt,22661000168108/phenergan">promethazine</a> to try to induce sleep. But this is a bad option. The Australian Medical Association specifically recommends <a href="http://www.smh.com.au/national/australian-medical-association-warns-against-sedating-children-on-long-journeys-20150405-1mesd0.html">parents do not do this</a>, as sometimes it can have the reverse effect and make children less sleepy and more active. These types of <a href="http://www.medsafe.govt.nz/profs/PUArticles/Mar2013ChildrenAndSedatingAntihistamines.htm">antihistamines are also known to depress breathing</a>, and in the low oxygen environment of the aircraft this can be especially dangerous. If you feel you or another family member will need sedation when flying, don’t use an antihistamine. Consult your doctor or pharmacist for a more suitable medication. Examples include prescription sleeping tablets, such as <a href="https://sleepfoundation.org/sleep-topics/melatonin-and-sleep">melatonin</a>, or natural remedies, such as <a href="https://www.webmd.com/vitamins-supplements/ingredientmono-870-valerian.aspx?activeingredientid=870">valerian</a>. <h2>What to do before and during your flight</h2> Before you fly, if you’re taking any form of medication, it’s recommended you meet with your doctor or pharmacist to discuss the suitability of your medicines. They may advise you there’s little risk for you, or if there is a risk, they may recommend a different medicine for the trip or recommend a new medicine to reduce the risk of blood clots. During your flight, don’t take antihistamines, and reduce your chance of a blood clot by drinking lots of water, stretching in your seat, and moving about the cabin as much as is appropriate. Finally, the effects of alcohol can be increased when flying – so drink in moderation, and try to avoid tea, coffee, and other caffeinated drinks as these can have dehydrating effects and make it harder to sleep. Image credits: Getty Images This article originally appeared on <a href="https://theconversation.com/which-medicines-dont-go-well-with-flying-90222" target="_blank" rel="noopener">The Conversation</a>.

Travel Tips

Millions of Aussies to be eligible for half-price medicines

Massive changes are underway for millions of Aussies as the federal government is moving to cut the cost of prescription medicine. Health minister Mark Butler announced that patients will be able to double the number of scripts they can receive, from one month’s supply to two months. From September 1, general patients will be able to save up to $180 a year if their medicine can be prescribed for 2 months, concession card holders will save up to $43.80 per year on medicine. Under the reform, which is to be included in May’s budget, 320 different medicines treating chronic conditions such as cholesterol, heart disease and hypertension will be dispensed in 60-day doses rather than the current 30. They will still be subject to the current price caps, so instead of paying a maximum of $30 for a 30-day medicine supply, those affected will pay $40 at most for a 60-day supply. One of the ideas behind it is that Aussies won’t have to visit a doctor or pharmacist as often. The federal government said the change will bring Australia into line with other countries, including New Zealand and the UK, where patients already have access to multiple month medicines on a single prescription. "Every year, nearly a million Australians are forced to delay or go without a medicine that their doctor has told them is necessary for their health. "This cheaper medicines policy is safe, good for Australians' hip pockets and most importantly good for their health.” The overhaul of prescriptions has long been supported by the Australian Medical Association and was recommended by the indecent Pharmaceutical Benefits Advisory Committee in 2018. However, pharmacists have opposed the reform, with Pharmacy Guild saying the change would cost community chemists $3.5billion. Pharmacy Guild of Australia president Trent Twomey said the change does little to acknowledge a massive shortage in medications. “I'm all for cost-of-living relief and a cost-of-living measure but this, unfortunately, is just smoke and mirrors,' he told ABC TV. “If you don't have the medicine in stock, how do you give double nothing? Double nothing is still nothing.” Instead, the federal government needed to boost local manufacturing of pharmaceuticals to fix the medicine shortage, Twomey said. Dr Nick Coatsworth also agreed that the new policy could lead to major medication shortages for patients across Australia. “The medication shortage issue is not made up. “This policy could lead to Australians turning up to pharmacies and being turned away for medications they've been on for five-to-10 years,” he told Today. “I'm actually worried about this, it looks good at face value but I knew a lot about supply chains in Covid and Australians probably aren't quite aware of how ropey those supply chains are. “If we start giving people 60 days of medications instead of 30, people will miss out.” Opposition leader Peter Dutton has supported the Pharmacy Guild’s stance in an online video. "Many, particularly older Australians, but families as well, really rely on the relationship with their local pharmacist," he said. "The government's proposal at the moment is going to make it harder for pharmacists to do that work and have that relationship with their patients.” Nationals leader David Littleproud said regional, remote and rural Australians risked being impacted by the changes. "Thousands of Australians who need medications could suffer as a consequence, because doubling scripts for some might mean others miss out," he said. However, the reform has been supported by the Australian Medical Association, a doctor’s body, with vice president Danielle McMullen welcoming the change. “At the time we're talking about so many cost-of-living pressures, this will really ease the burden on patients across Australia,” she told Sunrise. “There are some situations of shortages in medicines at the moment but there will be a staged approach to this announcement to ease the burden on the shortages.” Health Minister Mark Butler said the changes will be launched in three states, each introducing around 100 medications. The first stage will commence on September 1 2023, with the second on March 1 2024, and the final on September 1 2024. Butler said the new prescriptions will reduce how often those living in rural areas need to travel for treatment and shed light on the issue of Aussies delaying or going without medicines they need due to high costs. “Every year, nearly a million Australians are forced to delay or go without a medicine that their doctor has told them is necessary for their health,” he said. “This cheaper medicines policy is safe, good for Australians' hip pockets and most importantly good for their health.” Butler rejected the idea that the scheme will cause widespread shortages, noting only seven medications on the list are currently scarce. From September 1, 60-day scripts will be available for the six million people prescribed the eligible medications. Image credit: Shutterstock

Money & Banking

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

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

Caring

Researchers puzzled by results of anti-inflammatory medications for osteoarthritis

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

Body

10 items you MUST carry in your travel medical kit

Health concerns are the last thing you want to be dealing with when on holidays, but unfortunately accidents can still happen when we are travelling. This is why a travel medical kit is one of the most important things you will pack. From simple first aid measures to equipment that will help you in instances where something more serious is occurring, a well-stocked travel medical kit is the hallmark of every sensible traveller. Here are 10 items you must include in your travel medical kit. We’ve also included some additional tips at the bottom of the article. 1. Adhesive dressings (Band-Aids) – When travelling we’re particularly susceptible to minor cuts. Adhesive dressings ensure these nicks and scrapes don’t get infected. 2. Antihistamine – These are essential, especially if you’re someone who suffers from allergies, as they allow you to control allergic reactions in foreign environments. 3. Bandages – Use bandages to create support structures for strained limbs, reduce swellings, hold dressings in place, and even as a makeshift sling. 4. Instant cold pack – These handy devices are especially useful when it comes time to deal with any swelling issues or untoward skin reactions encountered abroad. 5. Antibacterial gel – If you’re in a situation when you need a pair of clean hands, antibacterial gel makes it possible without the need of water access. 6. Oral rehydration salts – Dehydration can quickly turn into a big issues overseas, so having a few oral rehydration salts on hand can get you out of a serious bind. 7. Safety pins – The practicality of safety pins knows no bounds, especially if you find yourself in a situation where you need to keep bandages or slings in place. 8. Thermal blanket – In an emergency situation a thermal blanket can help control body temperature and ultimately avoid the likelihood of someone going into shock. 9. Thermometer – It’s also quite useful to have a thermometer at hand just in case. Go for a digital design that’s easier to read in an emergency situation. 10. Tweezers – If you ever need to remove splinters when you’re overseas or do running repairs to adhesive dressings, a pair of tweezers becomes quite useful. Additional tips and pointers: <ul> <li>Keep you travel medical kit in a dry, cool storage location if possible.</li> <li>Make sure it’s in an easily accessible part of your suitcase or backpack, and make sure everyone you are travelling with knows where to find it.</li> <li>Before you head off, double check the contents of your kit ensuring any creams are up to date, bandages and dressings are properly sealed and all items are working properly.</li> </ul> Related links: <a href="http://www.oversixty.co.nz/travel/travel-tips/2016/03/teen-saves-flying-sheffield-to-essex-via-germany/">Teen saves money by flying from Sheffield to Essex via Germany</a> <a href="http://www.oversixty.co.nz/travel/travel-tips/2016/05/controversial-idea-to-shorten-airport-queues/">Controversial idea to shorten airport queues</a> <a href="http://www.oversixty.co.nz/travel/travel-tips/2016/05/5-ways-to-avoid-being-stuck-in-the-middle-seat/">5 ways to avoid the middle seat on planes</a>

Domestic Travel

"Backbone of our unit": Tributes pour in for Aussie medic killed in Ukraine

A young Aussie medic from Queensland has been killed by Russian artillery fire in the Ukraine, leaving his family mourning the tragic loss of their son. 27-year-old Jed William Danahay, from the rural town of East Nanango was killed in Eastern Ukraine on August 24 – with his death confirmed by the Department of Foregin Affairs – while working as a combat medic, assisting frontline troops when they were injured. At the time, Danahay was driving the medical vehicle when he was targeted by Russian forces and subsequently caught in an artillery attack. The family of the victim, his two older brothers and parents, have described his incredible character and desire to help others. “Jed lived his life trying to help other people, in his short time on this earth Jed did more things than most of us will ever do in a lifetime,” the Danahay family said in a statement. They described his adventurous nature, which led him on many journeys around the world. “Jed died doing what he believed in, helping people who needed it. He was at his heart an optimist and always believed that things should be better. “Jed’s comrades in Ukraine described him as the backbone of their unit, a hero and someone who they could all trust their lives to. “He will be missed dearly by his friends and family.” The family concluded by saying if anyone wants to help, they encourage them to support the Ukrainian people. Image: DFAT

Caring

New medical emergency hits Guy Sebastian trial

Guy Sebastian’s trial against his former manager faces more delays after another medical emergency unfolded just days after the presiding judge suddenly passed away. One of the jurors was rushed to hospital after suffering a severe allergic reaction during the lunch break - prompting the new judge to question whether it is practical for the trial to continue, as reported by <a href="https://7news.com.au/entertainment/celebrity/guy-sebastians-ex-manager-trial-resumes-c-6811553" target="_blank" rel="noopener">7News</a>. Judge Timothy Gartelmann announced that he would be taking over the trial on Monday, and with several jurors handing him notes raising concerns about future commitments, he said he would deliberate overnight once he found out about the welfare of the ill juror. “I will then make a decision about whether or not it is practical for individual jurors and indeed the trial itself to continue,” he said. Sebastian’s former manager, Titus Emmanuel Day, has pleaded not guilty to 50 charges, including allegedly embezzling money owed to Sebastian through royalties and performance fees, as well as 50 alternative counts of larceny. <a href="https://www.oversixty.com.au/finance/legal/guy-sebastian-fronts-court" target="_blank" rel="noopener">Beginning his testimony</a> on Wednesday, May 4, the Voice judge testified that Day promised him 10 percent equity in his company 6 Degrees - which Day managed him through for nearly a decade - in recognition of his importance as a “foundation client” in the company’s success. Email exchanges tendered in court also showed that Day told Sebastian he would give him 10 percent ownership of Solar D, a sunscreen brand Day created. Sebastian said he then became an informal ambassador for the brand, conducting interviews and participating in a rowing event and photoshoot among other duties. He said he didn’t expect any payment for the work because the emails made it clear he was part-owner of the company. Sebastian said “there were requests for intros”, and when asked about Day’s character in relation to the company, he gave “him a wrap”. “He’s a good bloke, and I’m involved as well. There’s nothing to worry about,” he recalled saying. The trial is expected to continue under Judge Gartelmann on Tuesday. The funeral for Judge Peter Zahra, who presided over the trial until his sudden passing and was a highly respected and senior judge in the NSW District Court, will be held on Friday. In a statement, Judge Zahra’s family said he would be remembered as a “special soul”. “We have received many lovely messages and memories that demonstrate the type of person he was, he had a big heart and wanted to see everyone achieve more than what they ever thought possible,” the statement said. “In honour of our Dad and his life, we encourage everyone to have a hot chocolate and share a dad joke in his honour!” Image: Guy Sebastian (Facebook)

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Millions of Aussies to be eligible for half-price medicines

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

Researchers puzzled by results of anti-inflammatory medications for osteoarthritis

10 items you MUST carry in your travel medical kit

"Backbone of our unit": Tributes pour in for Aussie medic killed in Ukraine

New medical emergency hits Guy Sebastian trial

Our Partners

News

Shop

Catalogues

Contests

Entertainment

Travel

Health

Lifestyle

Finance

Property

Games

Information

Keep up to date

Search

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

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

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

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

Shannon Noll postpones show due to medical emergency

Embracing healing: The rise of medical cannabis in Australia

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

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

Drinking alcohol this Christmas and New Year? These medicines really don’t mix

"Get the medic": Grant Denyer collapses in first-look trailer for Amazing Race

Medical Research Future Fund has $20 billion to spend. Here’s how we prioritise who gets what

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

9 medical reasons your short-term memory is getting worse

Which medicines don’t go well with flying?

Millions of Aussies to be eligible for half-price medicines

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

Researchers puzzled by results of anti-inflammatory medications for osteoarthritis

10 items you MUST carry in your travel medical kit

"Backbone of our unit": Tributes pour in for Aussie medic killed in Ukraine﻿

New medical emergency hits Guy Sebastian trial

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"Backbone of our unit": Tributes pour in for Aussie medic killed in Ukraine