Sur­geon and lec­turer Dr Sarah Rayne looks into mi­graine treat­ments, gives us the low-down on swine flu and sug­gests reme­dies for dry, peel­ing lips.

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Q: A friend has been di­ag­nosed with swine flu – hasn’t it been erad­i­cated? How se­ri­ous is it?

A: We of­ten use the word ‘flu’ to de­scribe a case of the snif­fles, but if you’ve had real in­fluenza, you’ll know that the com­bi­na­tion of fever, cough (usu­ally dry), headache, mus­cle and joint pain, sore throat and runny nose can be a ter­ri­ble ex­pe­ri­ence. Hap­pily, your body learns im­mu­nity to flu, which is why we don’t ex­pe­ri­ence it all the time – but the virus can mu­tate to fool our de­fences. A new strain can cause a pan­demic. In 2009, when swine flu first hit, no one was im­mune, so sev­eral peo­ple were af­fected and some even died.

But many have be­come used to this strain, and H1N1 ‘swine flu’ is part of the nor­mal vari­ant of flu in­cluded in the flu vac­cine ev­ery year. So, we haven’t got rid of it – we’ve be­come used to it. Sci­en­tists at the World Health Or­gan­i­sa­tion track out­breaks, on the look­out for the next world-threat­en­ing mu­ta­tion. In the mean­time, get a flu jab, par­tic­u­larly if you’re el­derly, preg­nant or have a weak im­mune sys­tem.

Q: I can’t find any in­for­ma­tion on the At­lasPRO­fi­lax or At­las Orthog­o­nal treat­ments. A Scan­di­na­vian friend said it cured her mi­graines. Do you know any­thing about them?

A: Both these tech­niques are ma­nip­u­la­tion and mas­sage tech­niques of the up­per spine. I don’t know much about these pro­ce­dures, but hav­ing looked at the sci­en­tific (and lots of the non-sci­en­tific) in­for­ma­tion, I’ll try to tell you about them.

The at­las is the first joint in your neck and is a small ring-like bone that the skull (4–5kg) rests on. The bone en­cir­cles your spinal cord and the blood ves­sels sup­ply­ing your head; other im­por­tant struc­tures sur­round it too. Pro­tect­ing this area is cru­cial – it’s why we have high head­rests in cars or car seats for kids. Doc­tors are also re­luc­tant to ‘in­ter­fere’ with this area: one wrong move could be cat­a­strophic.

Mi­graines, ear trou­bles and other gen­eral pains have been linked to pain in the bones and mus­cles of the neck. In some cir­cum­stances, prac­ti­tion­ers of these tech­niques sug­gest this may be be­cause these bones aren’t per­fectly aligned. Com­mer­cial tech­niques like these (some of which are avail­able in SA) have been de­vel­oped, and it’s claimed they can de­crease these prob­lems through ma­nip­u­la­tion and mas­sage.

Not many stud­ies show that they work: some show that symp­toms im­prove, but this may be due to an un­der­ly­ing prob­lem that’s been cor­rected, or be­cause mas­sage and ex­er­cise help most peo­ple (like a placebo ef­fect). Pro­ceed with cau­tion, and visit rep­utable prac­ti­tion­ers who will con­sult with you be­fore pre­scrib­ing treat­ments. If you have mi­graines, see your GP, a mi­graine spe­cial­ist or a physio as a first step.

Q: My lips are con­stantly peel­ing and dry. I don’t use matte lip­sticks or overuse lip balms – could it be a sign of some­thing else?

A: Prob­a­bly not. Your lips don’t have the same sweat glands as the rest of the body and are very ex­posed, so are prone to dry­ness. Add to that a habit of bit­ing your lips or pick­ing at dry skin and you have a recipe for sore, bro­ken lips! Try not to lick them (this can make them more cracked as the saliva dries) and use a bar­rier cream with sun pro­tec­tion. You can’t overuse lip balm but you can use the wrong ones. Avoid sticks that con­tain wax. Ap­ply an emol­lient cream from a tube (not a pot – re­peat­edly dip­ping your fin­ger into a pot can in­tro­duce germs). Mois­turise your lips with a thick layer be­fore bed – out­side the lip line too.

Dry, sore ar­eas at the sides of your mouth could be ‘an­gu­lar cheili­tis’ which may be due to ill-fit­ting den­tures or a nu­tri­tional de­fi­ciency. Sud­den red­ness or pain may in­di­cate an in­fec­tion, so have that checked out.

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