There are side effects heres your host dr coston out. Hello and welcome to in good shape paying is not a bad thing in and off itself because it wants you with it something wrong is going on inside your body but theres a problem when the pain gets chronic like an austere freitas in migraines and then you have to see a pain doctor like doctor think here at the franciscos hospital in berlin and hes the head of the pain clinic. Whats patients with severe chronic pain really need is a companion a professional companion who is helping them to fight the pain and to have a goal for the future. Well i think we all have something. Home and this is ok because if youve got a serious to say. Its ok to take a pill but be way up north and the dangers in some medications have serious side effects which are really hard in the body. As 4 years ago she became a patient in her own clinic for chronic pain have become unbearable. Thanks madson have been i often feel pain in my back at work i forget my job requires me to lift heavy patients and push heavy beds around things like that and that machine must. And so ive been in pain for about 20 years. Shes been through a lot of various doctors different therapies and lots of painkillers. But painkillers often have side effects. And if you think you can just keep treating pain yourself without going to a doctor and its been going on for a long time you can get very dangerous. One reason is you might not be medicating in the best way for the condition and the side effects can make your life difficult. And. The reason the painkillers like im p. Profound and aspirin have side effect is due to the way they work injured or inflame tissue releases certain fatty acids these are converted by socalled cox enzymes into messengers substances known as prostate gland ins these messenger substances bind themselves to pain receptors at the nerve endings they transmit the pain signal to the Central Nervous system. Profer an aspirin and similar drugs dampen the cox enzymes activity the body produces fewer prostitutes and ins and the pain goes away across the plantains also regulate other. Bodily functions like blood clotting liver function and the regeneration of mucus membranes in the got. An overdose of these over the counter painkillers can cause kidney damage liver damage which in some cases then requires Organ Transplants and you can have stomach bleeding regions are also more at risk of having a stroke especially patients who already had a heart attack so they should be very cautious about these drugs. Is also a patient a pain clinic she has multiple sclerosis and has had severe back pain for years several operations didnt help. Youre always looking around for something to relieve the pain so of course i took over the counter drugs my experience was that they didnt help. But the side effects were terrible. My stomachs in terrible shape i often have no appetite and have to throw up. Because the side effects were so bad doctors switched to prescription opioids opioids actor director lee in the Central Nervous system and the brain there they block the transmission of pain signals between nerve cells opioids dont cause the typical side effects of over the counter painkillers but theres the threat of overdose and addiction and their effect also diminishes over time. Thats what happened to take enough i took. This was the opioid stopped having an effect that happens often so if you take opioids over a longer period of time they stop having the desired effect. So marcus young blue doesnt prescribe either opioids or over the counter painkillers as a daily treatment for pain. Instead he and his team of specialists therapists and psychologists develop tailor made treatment plans for each of their patients. And. We give our patients a very thorough orthopedic examination from head to toe. Its not enough to simply look at an m. R. I. And say you have a herniated disc. Or a constriction. Especially with pain patients you have to take a holistic approach to get down to the different causes or consequences of. Thank you enough doesnt need opioids anymore thanks to the therapy she received in a pain clinic she now only takes one medicine that cannabinoids spray but m. S. Patients often prescribed. And im glad that it still gives me some relief its the only thing that does im also very careful with it because im too afraid that something will happen again. I just yet. Blitz and like you know now both know that painkillers cant heal you they can reduce the symptoms but in the long run they can also make you ill. Just kinds of medical it doesnt make sense to just take painkillers for 4 days wonder why its not Getting Better and hope it will go away on its own thats not a good approach. Booklet isnt pain free yet but shes learned how to deal with the problem and she does exercises that help and definitely have no side effects. Hes an anesthesiologist and a specialist in healing that is and thanks for having me today and lets start this kind of consultation lets kick it off with a question. Krista from lena writes that his girlfriend often has a headache and she always pops tablets to treat the headaches another is the little concerned about the side effects so what do you think do you have to take painkillers and headaches where the limits are crossed of all i think its to take pills when you have severe pain because we have to function we wont be happy for life but we should not forget that these painkillers can never receive you side effects especially if you go above the allowed limited dozers but we have much smarter ways especially when we can change our lives our behavior they have exactly the same alive so you little bit conservative about this and say you can treat headaches in a different way not all of us with pills but as a g. P. I know that there is Something Like a pain memory what about this we can have pain memory which can be biological. Nerve damage and then the whole brain is changing the structure but this is quite rare and much more common is the social pain memory. Where we change our behavior. And we changed our role from a normal person to the role of pain patients which is a socalled social pain memory but sometimes you catch to take medication you have to take a pill and then there are side effects that can be stomach pain stomach ulcers that can be bleeding and they can also be problems with the heart and patients must know about that so its about the non steroids pain medication yes but there are newer drugs of the same class which are safer for the stuff we have the so called to cook soups which would cause really less problems with the stomach but they have exactly the same problems for the hot so if you have patients so who have a severe Heart Disease coronary Heart Disease they should take these drugs only was a caution so sometimes as a doctor we have to switch from those kinds of medication to more centrally acting structures and drugs like opioids so when we have to prescribe this are in general the opiates are not toxic so they do not cause damage to the internal organs and. I prescribe them if i think they are useful so we try to determine a treatment goal. For example that the patients kind of a better sleep at night that they can walk better. They can sit longer they can think better have more happiness in life and so we have this defined goal of what we have and then we can we can figure out if with the help of these opioids we can attain this goal. Addictive or kids can be addictive if they have a very rapid onset of action in the brain and this is if you take them intravenously or you take drops but if you take retard tablets or plasters theres no problem at all but there isnt a crisis in the United States about 2000000 people got addicted and this is because this. Predetermining treatment i think and with all of the patients the patients the physician. Patient patients. And its always very important to find a type of. Casting hennings daughter nicole and granddaughter mira have come to visit us the 54 year old does her best to be there for her family. But the frequent pain she experiences means that even a simple meeting like this can be hard to keep. One person one moment the worst thing is that the headaches come on at the most inconvenient. You may want to go out and then be hit with a headache. I try to avoid Public Events because its lots of hustle and bustle. Few tortue loud. And thats too much of a strain for me. Caston suffered from different kinds of headaches since she was a child and. Over time they got worse. Shes learned to identify what kind of headache is coming on. Now she can put into words the type of pain that shes experiencing as. Tension headaches all involved pressure not a hammering or anything like that more the pressure as if you were wearing something tight wrapped around your head. And migraines come either from the right or the left side and thats the kind of throbbing or hammering in your head. Rise to see you come in. These days shes managed to get the migraines under control thanks to a category of drugs called triptans. Every 3 months shes given a low dosage injection of the neurotoxin botox to. Class to play a role in migraine formation it also blocks neurotransmitters that can trigger migraine attack patients get injections every 3 months for most of the migraine is reduced to a much more bearable level tweet which is most. Cancer and also takes antidepressants to alleviate her tension headaches. These kinds of drugs can help some patients have fewer and less severe headaches. But even if theyre less painful than before cast and still get tension headaches almost every day. For additional relief she goes to physio therapy she suffers in particular from tension in her shoulder and neck a common complaint among patients with tension headaches. And. You have to take a closer look at the tension headache to see where the tension is coming from the tension in the neck because somewhere else so you have to examine it very closely. It can have its roots in stress or Anxiety Disorders there are quite a few different causes. And. Exercises that help strengthen core muscles can help ease neck tension but regular training is key over the years cancer and got used to taking painkillers on a daily basis but that itself took its toll. So i wish to comment in the i used to take drugs constantly just to get through the day. And of course i had to find a way to stop that because too many painkillers can cause even more headaches. And thats the opposite of what you want. With. Cutting down on pain killers wasnt easy but captain hasnt given up she works full time in a large section of thorazine a big challenge for someone who is constantly in pain but shes found ways of coping. And if we are. In the past i would come home and do all the chores right away start i got up early in the morning and did everything. And if someone wanted something from me i didnt say no but now im taking a common approach. She has spent the evening during things she enjoys the focus is on activities that help her to relax. We just saw in the report that pills cannot always solve the problem when it comes to chronic pain so how important are psychological aspects and Pain Management. Psychological aspects of very very important pills just just working on one some ethic specific small part of the pain. But we must know the pain is a. Is just one aspect of the whole of the whole system of the human and the human consists of a soul of emotions of feelings and of the body so if we want to be successful or see the patient as a whole unit which is complex and if you just treat a small part of it this will not help could tell you what kind of factors complicate Pain Management on the biological side to we have neuropathy pain which is pain of the nerves which is very hard to treat but we also have. The knowledge that pains influenced by psychological problems which can be depression Anxiety Disorders posttraumatic stress disorder from soldiers etc and when we have patients who suffer from both sides from the biological side and from the psychological side we must take both aspects into consideration and treat both as pic the pair of at the same time so here you are patiently and you offer a holistic approach to Pain Management so ho often does it happen that patients have to stop taking pain medication altogether before you can treat them never. Patients never have to stop any medication before they come to us because we offer at the same time we offer a new type of treatment. And sometimes we decide together with the patient that its wise to decrease the previous pharmacological treatment to go down with a dose to replace it by a better type of treatment which can be another drug which can be a kind of psychological treatment so patients dont have to worry that if they come to you with that youre texting away from them they never have to very they never have to vary and see so its a g. P. M. Equated to 2 kinds of patients one which im quite hypochondriac if somethings painful they just come to me and say i want to have some pain medication and on the other hand there are some patients who are really in pain they dont want to take anything so how do they decide when to see a doctor i think. Patients go to a doctor if there are things they will go to a doctor from my side as a physician not as a patient i would say i would recommend if the pain is so such a big impact on my daily life and the impact can be problems with sleeping with walking with happiness then i should try to visit the doctor but its always good 1st to try to solve my problems by myself but if its not working i should think about talk with somebody who is professional and you as a professional can you always heal pain no i cannot well what i can or what i like to do is i like to listen to my patients have. Their problems. Really because a lot of this job and. But the and patients normally are very happy if we really talk aboard it if they have the feeling i understand them and most of the times we can help somehow by the complete complete turn up was there all pain is not realistic unfortunately its very horrible things for this very interesting talk and if youve got any questions to our experts be sure to read to me in email. In good shape your Weekly Health show one that covers many aspects of health care we look at whats new in medical treatment nutrition fitness and beauty we just cus these topics in depth with specialists and our field opportunities to pose your own questions so get in touch. And aspirin a day reduces your chances of having a heart attack or stroke unfortunately thats a myth if youre healthy taking aspirin on a regular basis when youre healthy can be quite dangerous. Over 10000000. 00 people die each year from heart attacks and strokes. These cardiovascular diseases are the number one cause of death worldwide. For decades aspirin was seen as an effective drug for preventing vascular disease and strokes. By the wonder drug was one of the most popular pills in the history of medicine. Around the world millions of Healthy People over 60 have been advised to take an aspirin a day to lower the risk of heart attack. As a blood thinning medication it prevents blood clots from forming clots in the arteries veins and heart can cause heart attacks and strokes. So taking an aspirin a day for heart health would seem to make sense. But its not that simple in fact the drug can have serious side effects. Gastrointestinal specialist mathias explains. Ask if. Aspirin is a medication that inhibits particular proteins in the stomach and the gastric mucosa but we need these proteins in order for the gastric mucosa to regenerate if that doesnt happen its susceptible to injury to show these injuries might start to bleed. Effect. So people who take aspirin on a regular basis could have an increased risk of bleeding from the lining of the stomach and doesnt really prevent cardiovascular disease. Stop at the system and the aspirin and reducing events in the elderly trial known as asprey looked at 20000 adults over 70 with various risk factors such as high Blood Pressure high cholesterol and diabetes. The aim was to see whether low dose aspirin 100. 00 milligrams a day could prevent cardiovascular disease it showed that it led to a minimal reduction in cardiovascular diseases such as heart attacks and strokes. The asprey trial divided 20000 people into 2 randomized groups. Over the course of several years one group was given aspirin every day the other group placebo. The participants were unaware which group they belong to. The study showed that aspirin did not significantly reduce the risk of heart attacks or strokes when taken by older adults who hadnt experienced the condition before. The risk of serious bleeding among the aspirin takers was increased compared to the play. Sieber group. In recent years the idea that aspirin protects against cancer has been gaining traction. 3 study looked into that as well. So i wanted to show. Some types of it actually transpired that there was an increase in the incidence of tumors the principle of primary prevention of cancer which is the prevention of tumors in the elderly couldnt be proven. So id say that aspirin has no overall effect on cancer prevention. All in all not be the wonder drug its being touted as in particular as a preventative measure Healthy People shouldnt be taking it for primary prevention of cardiovascular disease the risks far outweigh the benefits. But for those who have a history of heart attack or stroke there is indeed a proven benefit. Blood thinning properties can help reduce the risk of a repeat event. For some its a medical that for others its. Im talking about the healing powers of. More specific its active ingredient kennedy does or thought. Which is intoxicating effect that may help against many. C. B. D. Is one of the active ingredients in cannabis its touted as a remedy for all kinds of diseases but do the products actually help against migraine assman or even diabetes like the advertising promises. Neurologist and Natural Health practitioner dr. Has studied the issue he says more research is needed he. Claims that its an antioxidant antiinflammatory effective in treating north sea and effective in inhibiting epileptic seizures are for the most part actually true. Basic research has been done in the areas i just mentioned and there are also individual clinical studies for example studies about people who have epilepsy that doesnt respond to other medicines but c. B. D. Works. Despite the positive benefits they havent been enough studies done on the ones that were done were too small in scope and in some cases when their quality was lacking it often doesnt count. Those who draw the wrong conclusions from all the claims made these days could even harm that Health Rather than help it. If someone for example reads in a brochure about the anti diabetic effect of c. B. D. That it helps reduce blood sugar levels but it could give diabetic patients false hope when they might think they can reduce their insulin dose in the worst Case Scenario they do it without consulting a doctor they can put themselves at serious risk. In general advice is caution he warns his patients not to take large doses of c. B. D. Thats a. State. Do you limit experience range anxiety to these 2 electric cars should ease your concerns. On the ram challenge the curate he takes on the audi strong. Compound the metro s. U. V. Against a heavy cruiser. Is the comparison unfair or just david versus goliath read. 30 minutes on w. O. Ws crime fighters are back africas most successful in radio drama series continues this season the stories focus on hate speech color of prevention and sustainable chocolate production all of the sos are Available Online and of course you can share and discuss on africas Facebook Page and other social media. Platform. Fighters tune in no. Get the beethoven is for me. Its for. Children is for. Beethoven is for the beethoven is for every law being told in 2020. The 50th anniversary here on d. W. Each stop tells my story. Of the people who climbed to me bill. Daley kasab to me. I am not too dumb to come in. On this but a mind. Body in the centuries they built me they created something charming the absolute. Too much as i must destroy it. I have mocked my cities days for centuries and accompanied my country to its final hours until the day i mean. Not to dumb to believe dance and fool and. Play. The business day doubling news live from berlin its closing time in the city of los paris by. Served their last drinks as francoise all nonessential business is to close the spine does a step further until residents to remain inside their homes. To control the spread of the corona bars. Here in germany shops remain open and many people are still out and about but there is plenty of evidence of panic bonnie as shoppers prepare for potential pointing. And in the u. S