The Washington Post - USA (2020-10-20)

TUESDAY, OCTOBER 20 , 2020. THE WASHINGTON POST EZ EE E3

HEALTH NEWS

Q: Are there specific precau-
tions I can take to counter the fact
that I’m allergic to the flu shot?
I’m worried, and I assume others
in my situation are as well.
Linda in Florida

A: Health experts have told us
over and over that it is especially
important this year to get a flu
shot because of the pandemic.
They want to prevent a bad flu
season, which, combined with
coronavirus outbreaks, could
overwhelm hospitals.
We’ve recently gotten several
questions about egg allergies and
vaccines, some of them related to
the flu shot and others to a poten-
tial coronavirus inoculation.
Most flu vaccines are developed
in eggs, which means there could
be some lingering egg protein in
the shot you receive.
The first thing you should do is
talk to your doctor to see whether
you actually cannot receive a flu
shot. The Centers for Disease
Control and Prevention says hav-
ing an egg allergy that is severe
enough to prevent you from get-
ting a vaccine is exceedingly rare.
Even people with such a severe
allergy that they have “required
epinephrine or another emergen-
cy medical intervention” from a
previous reaction to eggs can still

get any licensed flu vaccine, ac-

cording to the CDC. It should be

administered in a medical setting

such as a physician’s office, clinic,

health department or hospital, so

you can be monitored for a reac-

tion and treated, if necessary.

You could ask your doctor

about two licensed flu vaccines

for this season that the CDC says

are egg-free: Flublok Quadriva-

lent and Flucelvax Quadrivalent.

There is one circumstance in

which the CDC recommends not

getting a flu shot. “A person who

has previously experienced a se-

vere allergic reaction to flu vac-

cine, regardless of the component

suspected of being responsible

for the reaction, should not get a

flu vaccine again,” the agency

wrote.

If you’re one of those cases,

Linda, you should be more mind-

ful of spreading germs as the

weather gets colder and protect-

ing yourself from them — some-

thing we all should be doing,

frankly. We have learned a lot

from the past eight months. We’re

wearing masks now. We’re wash-

ing our hands more and limiting

close contact with other people.

All of these things will also help

decrease flu transmission in the

fall and winter.

— Angela Fritz

I’m allergic to the flu shot. What can I do to take

precautions during flu season and pandemic?

HEALTH SCAN

As humans, our health con-
nects us to uncertainty, mortality,
faith, autonomy and more.
So does art — and Rx/Museum,
a thoughtful project that con-
nects art and medicine, finds
themes of health and humanity in
both.
The project was developed by
educators at Penn Medicine, the
University of Pennsylvania and a
variety of museums and art insti-
tutions throughout Philadelphia.
It’s a thought-provoking pre-
scription for reflection and learn-
ing, and you don’t have to be an
artist or a clinician to enjoy it.
Every Monday, the project
sends subscribers an email that
includes a piece of art work and a
short essay that delves into chal-
lenging themes that connect the
art to medicine. The essays are
reflective and wide-ranging, cov-
ering uncertainty, death, suffer-
ing, salvation and more. Each is
accompanied by a list of sources
so that readers can learn more.
One recent newsletter includ-
ed thoughts on permanence and
the participation of AIDS patients
in their own care tied to “Strange
Fruit,” an installation by artist
Zoe Leonard that was exhibited at
the Philadelphia Museum of Art
in 1998. Another featured Henri

Rousseau’s “Woman Walking in

an Exotic Forest” and tied it to

questions of colonialism and di-

versity in medicine.

Contemplating Horace Pip-

pin’s 1 940 painting “Supper

Time,” the team discusses c ultural

bias. Pippin, a Black artist who

used his work to reflect on racism

and slavery, regularly had his

work branded as “primitive” and

“tribal” by art critics. The essay

connects the art world’s disquiet-

ing reception to Pippin’s work to

clinicians’ implicit biases and the

use of terms like “noncompliant”

or “unmotivated” to describe pa-

tients.

“We’re trying to weave an inter-

esting multidisciplinary lens of

clinical medicine and anthropol-

ogy and social justice,” Lyndsay

Hoy, a ssistant professor of clinical

anesthesiology and critical care at

Penn Medicine and the co-creator

of the project, told the Daily Penn.

Sign up to receive the weekly

email yourself — or just tool

around the intriguing list of

themes the consortium has al-

ready explored — at rxmuse-

um.org.

— Erin Blakemore

ART

Weekly newsletter explores themes such as

diversity in medicine, suffering and uncertainty

rxmuseum.org

H

eadaches are the most

common neurological

symptoms we experi-

ence. And although

they affect younger

people at a higher rate, they still

occur in many older adults.

In a 2018 survey, almost 10

percent of people between ages

65 and 74 — and about 6 percent

of those 75 and older — said they

had recently experienced a mi-

graine or severe headache. For

some, the familiar pain emerges

twice a month or more.

Though headaches may be

common, they should not be ig-

nored or dismissed. Headaches

sometimes signal more danger-

ous conditions — including some,

such as a stroke, that must be

addressed immediately. They can

also be a symptom of covid-19,

appearing in about a third of

diagnosed patients in the United

States. And even though most

headaches do not require medical

attention, there’s no need to just

grit your teeth and get through it.

Here is expert advice that can

help you prevent and treat head-

aches more effectively and more

safely.

Common types

There are about 200 types of

headaches, says Juliette Preston,

assistant professor of neurology

at the OHSU School of Medicine

and medical director of the uni-

versity’s headache center.

Two of the most common types

are tension and migraine. Most

tension headaches are mild to

moderate, usually with pain on

both sides of the head, and with-

out any other major symptoms.

According to an Italian study

published in 2008, about a third

of older adults experience at least

one over the course of a year.

Migraines, on the other hand,

generally involve moderate to se-

vere head pain as well as an array

of other symptoms, such as sensi-

tivity to light or sound, nausea

and temporary problems with

cognition, says Niushen Zhang, a

clinical assistant professor of

neurology at Stanford University.

Migraines can occur in men and

women but are more frequent in

women, often worsening during

menopause and subsiding soon

after.

If, however, you’re 50 and older

and experience what seems like

your very first migraine, the prob-

ability that it is truly a migraine is

relatively low. There may be an-

other condition at work.

Similar symptoms can also

point to what’s known as a hypnic

headache, which is rare but oc-

curs most often in older adults.

Its defining symptom? It wakes

people from sleep at around the

same time each night, which is

why it’s known as the “alarm

clock headache.”

Preventing frequent aches

Hypnic headaches are general-

ly easier to manage than mi-

graines. A little bit of caffeine

before bed — about 40 to 60 mg in

a tablet, or about a half-cup of

brewed coffee — usually prevents

them without keeping people up

at night, Preston says. But don’t

try this without talking to your

doctor first. Just be sure to men-

tion the time of your headaches so

that they are not mistaken for

migraines.

Even for migraines and recur-

ring tension headaches, however,

don’t reach for the meds right

away. There is evidence that life-

style changes can help prevent

headaches, especially migraines.

“Twenty minutes a day of aerobic

exercise actually decreases mi-

graine frequency and severity,”

Zhang says.

For many headache types,

keeping consistent mealtimes,

bedtimes and wake times can

help, as can making sure you’re

staying hydrated by drinking

plenty of water. For migraines, a

neurologist can also help you

identify possible triggers, such as

dehydration.

In one classic study of people

who experience migraines, most

subjects reported at least one

external factor that seemed to

trigger their head pain. The most

common triggers were stress,

hormonal changes, fasting,

weather and sleep disturbances.

In the past, trying to avoid all

potential triggers was a popular

strategy. But newer research sug-

gests that many triggers can be

hard to identify and impossible to

avoid. And other studies have

suggested that simply adhering to

a healthy lifestyle — which would

naturally include avoiding things

such as toxic odors, hunger, dehy-

dration, lack of sleep, etc. — may

actually be more effective than

trying to avoid all potential trig-

gers, such as stress and noise.

Your doctor can also help con-

nect you with other treatment

options if basic interventions are

not helping. For instance, there is

strong evidence that physical

therapy c an help prevent tension-

type headaches from returning.

Acupuncture may help prevent

frequent headaches, Zhang says.

And research has also suggested

that biofeedback — which typical-

ly uses electrical sensors on your

body to make you aware of and

help you control physiological

processes — may reduce chronic

pain, including from headaches.

Serious stress can also cause

recurrent headaches. In those

cases, cognitive behavioral thera-

py, or CBT, can help as well. Ask

your doctor for a referral to a

therapist who practices it.

Using meds properly

You should take medications

with caution, especially if you get

headaches regularly. But over-

the-counter (OTC) or prescrip-

tion medications can help ease

the discomfort of both tension

and migraine headaches.

Older adults are more sensitive

to the effects of medications,

Preston says. For pain relievers

such as ibuprofen (Advil and ge-

neric), naproxen (Aleve and ge-

neric) and aspirin, side effects can

include dizziness, cognitive is-

sues and increased risk of gastro-

intestinal bleeding. So you should

keep your use to a minimum.

Acetaminophen (Tylenol and ge-

neric) is potentially safer for older

adults but also may be somewhat

less effective for headaches, ac-

cording to UpToDate, a tool for

doctors.

Be sure to follow dosing direc-

tions on the package. But if you

are taking OTC pain meds regu-

larly, that’s not enough: You

should also check with your pri-

mary care doctor and consider

setting up an appointment with a

neurologist to discuss your intake

of these meds in more depth. In

general, Zhang says, to protect

yourself from what’s known as a

medication overuse headache,

avoid taking pain relievers such

as ibuprofen and naproxen more

than 15 days per month. For some

medications, however, you’ll

need to keep that number far

lower, she cautions, which is why

checking with your provider is

important.

For people who get consistent

headaches and can’t tolerate OTC

meds, doctors may also consider cer-

tain prescription pills, Preston says.

When to get emergency help

Occasionally, a headache re-

quires immediate attention.

When someone 50 and older ex-

periences a type of headache that

is different from one they have

had before — even when it’s a dull

pain rather than explosive — that

“is usually a red flag to us,” Pres-

ton says.

And if it is accompanied by a

change in hearing, prompts a

feeling of weakness or numbness,

or gets worse when you change

positions — say, when you lie flat,

stand up, exert yourself, or bear

down — that’s a sign to visit the

emergency room.

“If it feels different, if it just

doesn’t feel right,” trust your own

judgment, Zhang says.

A doctor will try to rule out the

most severe conditions that could

be causing an odd-feeling head-

ache, including aneurysm, stroke

and other blood-vessel abnormal-

ities; tumor; and an inflammato-

ry d isorder called giant cell arteri-

tis, among other concerns.

But while it’s important to be

cautious, keep in mind that a new

headache is sometimes just that:

a headache.

© Copyright 2020 , Consumer Reports Inc.

FROM CONSUMER REPORTS

How to prevent and treat headaches

ISTOCK

3

decibels

U.S. residents have experienced a quieter world in
recent months — about 3 decibels quieter than usual,
according to University of Michigan research that
compared noise levels in the environment before and
after coronavirus-related social distancing and
lockdown requirements took effect. That represents
about a 50 percent drop in environmental noise
exposure, according to the study, published in the
journal Environmental Research Letters.
Environmental noise stems from such sources as traffic (cars, buses,
trains, planes), commerce and industry, construction, sporting events,
partying, dining and more. The study involved 5,894 adults (in
California, Florida, New York and Te xas) who were equipped with
devices that recorded data on the sounds they were exposed to for
roughly 90 days in spring 2020. Participants in New York experienced
the largest reduction in sound, and Florida participants experienced
the smallest. The overall drop brought the average environmental
sound level below the level generally considered to carry health risks.
Noise-induced hearing loss is the most common health problem
related to sounds, but chronic exposure to loud noise also has been
linked to hypertension, sleep problems, memory problems and more.
The ability of sound to cause health problems depends not just on
how loud the sound is but also on how long you are exposed to it.
T he pandemic’s worldwide effect on noise was noted in a recent study
in the journal Science. It found a 50 percent reduction in human-
generated noise around the globe, based on data from earthquake
detection equipment and attributed to changes in people’s activity
since the novel coronavirus hit.
— Linda Searing

THE BIG NUMBER

Consumer Reports is an

independent, nonprofit organization

that works side by side with

consumers to create a fairer, safer,

and healthier world. CR does not

endorse products or services, and

does not accept advertising. CR has

no financial relationship with

advertisers in this publication. Read

more at ConsumerReports.org.

B ARNES FOUNDATION, MERION AND PHILADELPHIA, PENN.

H orace Pippin’s 1940 painting “Supper Time.”

Pippin, a Black artist, regularly had his work

branded as “primitive” and “tribal” by art critics.

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