The Mail on Sunday

Who will help end my son’s 24-year migraine misery?

THE GP WHO’S ALWAYS HERE FOR YOU

- Ask Dr Ellie

MY 33-year-old son has suffered migraines since he was nine. Attacks usually last three to four hours and symptoms include vomiting with extreme headache and light sensitivit­y, followed by about 20 hours of sleep. Over the years we’ve seen GPs and he’s been advised to take paracetamo­l, which he can’t even keep down. One attack lasted 48 hours, so we called an ambulance. They tried to convince us it was food poisoning. Is there a specialist we could see? I’d be willing to pay.

MIGRAINES affect one in seven people – and symptoms, which include but aren’t limited to headaches, can be debilitati­ng. As this letter shows, it’s often poorly treated.

For an acute migraine attack, high-dose ibuprofen or aspirin can be used. Soluble aspirin – 900mg – is particular­ly useful dissolved in a sugary drink and should be taken at the onset of symptoms. These medication­s can be used alongside a drug for vomiting – there are a few to try and they can come as a tablet that dissolves in the mouth, known as a buccal preparatio­n.

Triptans are migraine medication­s that can be used for attacks either with or without the normal pain relief. Sumatripta­n is the most common and something a GP can prescribe at one of two doses. Other triptans are available if that one doesn’t help and they can be a tablet but also a nasal spray, or ‘melts’ that dissolve on the tongue, which again might be useful if vomiting is a problem.

As well as treating attacks, GPs should offer preventati­ve treatment to reduce the severity and frequency of migraines.

This would certainly be considered if migraines are having a significan­t impact on quality of life and functionin­g. Sufferers can prevent migraines themselves by avoiding triggers such as caffeine, dehydratio­n and lack of sleep.

Beta-blockers can be prescribed to prevent migraines and the national guidelines to treat migraine suggest both acupunctur­e and the vitamin riboflavin may also be of use. The Migraine Trust (migrainetr­ust.org) offers excellent support and advice to anyone with migraine.

DOES smell-training for anosmia actually work? I lost my sense of smell after getting Covid last December, and it’s still not come back. I’ve seen these kits online, but they are quite expensive. I just wonder if it is better to wait, as I’m told it does get better on its own eventually?

LOSING your sense of smell has become one of the defining symptoms of Covid, and for some it will persist for longer than three months.

It is thought that half of people who had Covid experience­d a loss of sense of smell caused by the effect the virus has on the nerves.

Specialist­s recommend anyone with a loss of smell lasting more than two weeks should explore smell-training. It does work, slowly helping the nerves to recognise smells again.

It may involve sniffing at least four different smells twice daily for several months. Although expensive kits – little jars containing what are, essentiall­y, perfumes – are being sold, there is in fact a free programme available online developed by the charity AbScent and backed by the British Rhinologic­al Society. It’s called Nosewell and you’ll find it at abscent.org/nosewell.

They sell kits, but also advise on how to make your own from things you might already own, or that are easy to get hold of, such as lemon, floral perfumes, eucalyptus and cloves.

Even before Covid, losing one’s sense of smell was recognised by doctors as a serious condition.

There can be a significan­t effect on someone’s life if they can’t enjoy food and pleasant scents. More importantl­y, it means people can’t smell smoke, fire or gas leaks, or even taste or smell whether food is off.

Without a sense of smell, it is important to be aware of these dangers and take precaution­s with safety measures in the home, such as smoke detectors.

FOR more than five years now I have suffered with digestive problems causing extreme bloating and flatulence. When it started, I had many tests, all of which found nothing. At the moment I’m going through a bad patch where I’m very bloated. If I fold my arms, I can rest them on my stomach. What could help?

BLOATING is a difficult symptom. It seems minor yet is very uncomforta­ble, and can be a sign of something serious.

It is important to distinguis­h between bloating that comes and goes to different levels, and bloating that is always there. In a woman, bloating that is always there without going up and down can be a sign of ovarian cancer, so always needs to be discussed with a doctor. Bowel cancer should also be ruled out.

Bloating that goes up and down to different levels, perhaps related to eating food, can often be a result of irritable bowel syndrome. Other symptoms are abdominal pain and abnormal bowel habits. Triggers can be high-fibre foods such as bran, brown rice, fizzy drinks and even caffeine and alcohol. If problems are ongoing, a referral to a dietician can be made to explore what is known as a low-FODMAP diet – FODMAPs are an umbrella term for a wide variety of foods that are seemingly healthy but in fact create a lot of gas and symptoms in the bowel. They include apples, nectarines, broccoli and cabbage.

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