ASK THE DOC
Specialist surgeon and lecturer Sarah Rayne on mystery headaches, burning nipples and whether or not you should skip breakfast
Q: I’m a 56-year-old non-smoker and quite fit. But recently I started getting severe headaches that seem linked to exercise. What’s going on?
A: Most people who suffer from headaches and migraines are told that exercise helps in relieving or avoiding them. However, there is a special type of headache called a ‘primary exertional headache’ that is actually triggered by exercise. It is similar to an ‘orgasmic headache’, which is triggered by sex.
In both cases, the underlying reasons are not clear but seem to be related to blood pressure and the supply of blood to the brain during exertion. It’s crucial, especially at your age, to have a full physical by a neurologist or GP to make sure there is no other cause for this, as a small bleed in the brain can also suddenly cause these symptoms. If there is no other cause, it can often resolve itself after 3-6 months. In the meantime, there are strategies and medications to help avoid the pain and help the blood supply during exertion. But get it checked out, stat. Q: I sometimes have a burning sensation in my nipple. Is it anything to worry about? I am 47. A: It’s always good to take note of any new symptoms or sensations you have and get them checked out if they don’t settle in a few days – and it’s especially important for breast problems. It is still all too common for women in South Africa to discover that they have breast cancer when it’s already reached an advanced stage.
Having said that, there are many problems in the breast that are not related to cancer, and this kind of pain can be one of them. Burning sensations, stabbing pains and itchy nipples can often be a sign of problems in the milk ducts just beneath the nipple causing irritation and inflammation. It’s called duct ectasia, and it can affect any woman but is most commonly seen in women who smoke. The inflammation can, at its worst, develop into an infection or abscess which needs treatment with antibiotics or surgery. In its earliest stages however, good breast hygiene, stopping smoking and wearing bras made from natural fibres such as cotton can help. The first step, however, is to get checked out by your doctor and have a mammogram/sonar done to confirm any diagnosis. Q: Breakfast – yes or no? I’m getting conflicting advice. I know fasting for 12 hours overnight is meant to be good for you, but so is kickstarting your metabolism with breakfast, isn’t it?
A: The concept of breakfast being ‘the most important meal of the day’ was actually part of a marketing strategy promoting breakfast cereals. Before then, people would eat whatever was left over from the night before, or something easy to prepare in the morning. However, studies have shown that eating breakfast is good for everything from concentration and memory to avoiding obesity. It helps you through the day, and also seems to be good for your health long-term by reducing the rates of diabetes, heart disease and high cholesterol. One study of overweight women found that their insulin and fat responses to lunch were worse if they habitually skipped breakfast. As for intermittent fasting: studies in mice suggest that restricting your eating to 12 hours of the day (so no late-night snacking!) assists in weight loss. I rarely pick a healthy apple over some chocolate cake late at night, though, so there may be other reasons snacking is bad! The simple answer is that a breakfast that includes more than 20% of your daily food is probably good as part of a well-balanced diet, and may help you stay young, healthy and slim.