Ask the doctors: Readers respond
Hello, again, dear readers, and welcome back to the letters column. We hope the first two months of 2024 have been treating you well, and that your Valentine’s Day is looking rosy. Your letters continue to be as interesting as they are abundant, so let’s get right down to business.
• In a recent column about severe headache pain, we said it can sometimes be a symptom of an underlying condition. A reader from Pennsylvania wrote to say this turned out to be true for him. “I had been suffering from blurred vision followed by debilitating headaches for a few years. Then one night, while out to dinner, I collapsed to the floor,” he wrote. “My left carotid artery was 90% blocked, and I had had a stroke. After 11 days in the hospital (and five procedures), I started my recovery and am 99% back to where I was prior. And I haven’t had another migraine since.”
A headache is a common ailment and can be easy to dismiss. Some important red flags include headache accompanied by blurred vision or slurred speech, sudden or explosive pain, a headache that occurs immediately after physical exertion, pain that continually escalates for 24 hours and headache accompanied by fever, stiff neck, nausea and vomiting. We appreciate your sharing your experience, and we are very glad to know you are having a successful recovery.
• A column about a small (just 17 participants) clinical trial that explored using stem cells to manage Type 1 diabetes continues to generate a lot of mail. For those of you asking for updates, there is now some news. In a statement released last November, the researchers announced that their stem cell-based treatment continues to yield promising results. The focus of the ongoing clinical trials is a small medical implant that contains lab-grown pancreatic islet cells. Islet cells in the pancreas produce insulin. The implant is designed to regulate blood glucose levels and reduce dependence on daily insulin injections. In a separate but related study, researchers are working on a version of these lab-grown cells that would fly under the radar of the immune system, and thus not require the use of immunosuppressive drugs. While very encouraging, it’s important to understand this all remains in the research stage and is not yet available to the public.
• In response to a column about the use of Botox for migraine, a reader asked if they would be eligible. “I suffer from migraines that radiate from the occipital nerve area in the back of my head,” they wrote. “I get at least eight each month. Can I be referred for Botox therapy?” The criteria that make Botox eligible for insurance coverage in migraine treatment include 15 or more headaches of at least four hours each month. It’s possible for those who fall short of the criteria to find treatment, but they would be asked to bear the cost.
Thank you again for your letters; we love hearing from you. For those of you asking for archived columns, you’ll find them at uexpress.com/health/ask-the-doctors/archives.
Send your questions to askthedoctors@mednet.ucla.edu.