Health news blog

Few of us have escaped the nagging headache that can accompany a cold or other infection. Headache is only one of the uncomfortable symptoms associated with infections, but head pain may be so severe that medical attention for the headache itself becomes necessary.     The exact mechanism by which an infection throughout the body and the accompanying fever cause headache is not fully understood. It is likely that the head pain is due to either or both the inflammation of sensitive structures or the dilation of the blood vessels that invariably occurs when the body temperature goes up.     Blood vessel dilation develops automatically during fever and is nature’s way of cooling the body by transferring some blood from internal regions to the skin, where it is exposed to air and thus cooled. The headache due to fever may resemble migraine because both are related to blood vessel dilation. The pain is often pounding, frequently hurts behind the eyes, and is aggravated by a sudden change in position, particularly bending over.     A headache that comes as part of a generalized infection and fever may be successfully treated by reducing the fever with medications like aspirin and acetaminophen or by resorting to a variety of home remedies such as cool baths or alcohol rubs. Aspirin and acetaminophen, of course, have both pain-relieving and temperature-lowering properties. Aspirin is best in this situation, however, because it has an ability to reduce inflammation which acetaminophen lacks.
*61\88\2*

• The relief of anxiety may greatly lessen pain.     Anxiety is a normal and universal emotion. As with depression, the distinction of abnormal anxiety in patients with physical illness is poorly defined. The clinical features and signs of anxiety are numerous. Patients with cancer may have fears relating to the uncertainty of the future, to bodily dysfunction, unrelieved pain or other symptoms, or it may be the fear of death itself. Panic attacks can occur which consist of sudden, unpredictable attacks of intense fear and physical discomfort, usually lasting 15 to 20 minutes.     Normal anxiety-Anxiety occurs normally in response to the stress and crises associated with cancer and its treatment. These episodes settle with time and general supportive care.     Adjustment disorder-reactive anxiety. Anxiety lasting longer than expected (more than 7 to 14 days) or exceeding the level regarded as normal and adaptive, may be classified as an adjustment disorder. Reactive anxiety follows a defined incident or stress and depressive symptoms frequently coexist.     Organic anxiety syndromes-In patients with cancer, anxiety can occur secondary to other medical problems.     Anxiety disorders-Generalised anxiety, panic disorders and various phobias may be precipitated or aggravated by cancer or its treatment. These patients have more severe and disabling symptoms which appear inappropriate and out of proportion to the medical situation. A generalised anxiety disorder is characterised by chronic unrealistic worries with autonomic hyperactivity, apprehension and hypervigilance.     Treatment-Patients with normal anxiety responses simply require good supportive care. Temporary use of a hypnotic at night and an anxiolytic by day is appropriate if the symptoms are severe. Brief supportive psychotherapy is frequently beneficial. Behavioural techniques including distraction, relaxation therapy and stress management techniques will help some patients. If significant depression is present, an antidepressant should be considered.     Benzodiazepines are the drugs used most frequently to treat anxiety. Drugs with short and intermediate half-lives (alprazolam, lorazepam, oxazepam) are preferred to longer acting drugs such as diazepam. Lorazepam has the advantage that it can be given sublingually. Midazolam can be given subcutaneously and can be included in a subcutaneous infusion with morphine.*80\55\2*