Physical Therapy
Headaches - Ibuprofen


Ibuprofen is a non-steroidal anti-inflammatory drug classified as a NSAID. As the acronym suggest, Ibuprofen (and aspirin) is used to decrease inflammation. Inflammation causes tissue to expand and generates nerve signals that are interpreted by our bodies as pain. In order to ease pain, we must decrease the inflammation.

Also like aspirin, ibuprofen is used to treat a wide variety of conditions - arthritis, abdominal cramps from menstruation and many others. But, like aspirin, it can produce side effects. Blood in vomit or stools, general stomach upset even dizziness are commonly reported.

Other potential side effects include allergic reactions, leading to swelling of the throat or tongue, fluid retention and ringing in the ears. Since it works by changing blood composition, as does aspirin, anyone who has had heart surgery should avoid it.


Those with a liver or kidney disease, too, should consult a doctor before taking ibuprofen. Patients with ulcers or those taking coagulation medication should as well. Anyone with high blood pressure or heart disease should find a substitute. Nausea is fairly common and diarrhea is sometimes reported.

Ibuprofen is not suitable for pregnant women though it's generally safe during early stages. It is particularly risky in the last trimester, as it may produce birth defects. The compound in ibuprofen can be passed through the blood stream into the fetus. Consulting a physician is a wise precaution.

All these side effects can be minimized by proper dosage and consumption. If taken in liquid form, use a carefully calibrated measuring spoon or small cup, rather than a teaspoon. Alcohol shouldn't be consumed with or just before hand, and the ibuprofen should be taken with a glass of milk or water.

In general, it shouldn't be combined with other over-the-counter pain medications, such as aspirin or naproxen. The list of other drugs that can interact unfavorably is, not surprisingly, very long. Some of the more common ones are steroids (prednisone, for example), lithium (such as Lithobid) and diuretics.

On the upside, ibuprofen has been shown to be very effective in treating a wide variety of headaches. Some, such as those produced by high altitudes (a condition called AMS - acute mountain sickness) respond very well to ibuprofen. That's good news for climbers and those who travel in planes frequently.

There has been a lot of research conducted on whether aspirin, acetaminophen, or ibuprofen works better in alleviating pain. The answer is different depending on the person. The most important thing to remember is that you should use what works best for you and what causes the fewest side effects.

The first information to consider is the patient's self-evaluation.

The Pap Smear and the Mechanic - video.i7i.us
The Pap Smear and the Mechanic - video.i7i.us

Unknown length - Feb 18, 2008

"The Pap smear and the Mechanic Once, my officer manager commented, "Why do these women get all dressed up for a routine Pap smear?" Adult medicine is very complex and a significant number of married females have sexual dysfunction associated with pain or other vaginal symptoms. Men often think that women want sex just as often as they do, "twice a day if possible!" If a woman has two children, works outside the home, the last thing she may want is "sex." Women are often forced to make excuses, like "I don't feel well; I have a headache." Men often react by threatening such women with "I am going to look for another woman." A jealous husband may say, "Are you saving yourself for another man?" In one extreme case, as soon as he got home, a husband would examine his wife's vagina to make sure no other man "had entered her." In my practice, there were no routine Pap smears. After the examination, the visits would turn into psychiatric consultations. Routinely, the latter part of the visit would take up to one hour as the women often expressed a maelstrom of personal conflicts and family problems. The Mechanic's wife was no exception. After the exam, the patient would get her usual dose of psychotherapy. The Mechanic took notice on how his wife would come home unusually happy after her Pap test at my office. He began to think that perhaps his wife and I were up to something 'sexual." Once we met, her husband became my patient and stopped thinking something so silly. I stopped doing pap smears because it was time consuming (the psychotherapy component) and there were too many false positive results. The Pap test too often was read as "Atypical Squamous Cells of Undetermined Significance" or ASCUS. Women should know that post-coital bleeding (bleeding after intercourse) can be an ominous sign. Cervical cancer is infrequent and about 3,500 to 4,000 die yearly in the United States. A patient I treated died because the Pap smear she had during her pregnancy three years before seeing me was inadequate. It had no ENDOCERVICAL cells. Your doctor should readily perform a wet mount of the Cervix, if there is a discharge, and rule out sexually transmitted diseases. The most important step regarding a Pap smear is the person reading the specimen, which is usually a cytotechnician, not a physician. A technician is usually paid less than a dollar per Pap test. If you have an HMO, the lab may be paid so little that I often do not trust such reports. When I stopped doing Pap smears, women were disappointed because they only "trusted me." In fact, it was the psychotherapy they wanted. Patients deserve about thirty minutes during these apparently "superficial" visits. In June 2006, the FDA approved Gardasil, vaccine for human papilloma virus (HPV). Merck is promoting this vaccine, which costs about 0 and is hoping to make it a mandate. That is, Merck wants government or a third party to pay on your behalf for the over priced vaccine. Healthcare is a finite resource. What about the 47 million uninsured Americans? How do we save them from readily treatable conditions that may only cost a few dollars? The best defense against cervical cancer is to insure that patients get quality care and that the laboratory is reimbursed well. Highly qualified personnel must study your Pap smear. You should get a copy of the report. It is your life. Luis A. Lomeli, M.D.

A headache can be deadly so can be a swollen & painful eye!
A headache can be deadly so can be a swollen & painful eye!
LuisLomeliMD
3 min - May 23, 2007

Headaches -A few comments that may save a life. An acute headache may not be as simple as it seems. Though most types of headaches are due to tension and/or migraine, infrequently that can represent serious life threatening conditions. For tension headaches, I usually recommend that my patients take Acetaminophen (Tylenol/generic), Diphenhydramine (Sominex), sedating, and caffeine if patient is healthy. Tension headaches are usually long-term, non-progressive and recur in the same form and often due to specific stressors. A patient with chronic tension/migraine headaches, however, may develop a new, unrelated, type of headache that may be due to a serious condition. If febrile (with fever), always consider Meningitis. The acute onset of the "worst headache ever" may be a life threatening intracranial hemorrhage, as from a ruptured aneurysm. At times, these patients may experience warning headaches that may become suddenly fatal. In 2006 (circa), an African-American singer had been experiencing warning headaches and died a week later from a brain hemorrhage. Sharon Stone, Actress, was properly diagnosed and survived a subarachnoid hemorrhage (bleeding around the brain membrane). These headaches can be severe and sudden. For this reason, I encourage my patients to avoid drugs that may promote bleeding, like aspirin, ibuprofen (Advil/Motrin), naproxen (Aleve) and other NSAIDs. Usually a CT-Scan is diagnostic, but there are a few exceptions. Throughout my medical career, I had a chance to review various types of legal medical cases that have resulted in death. In one case, a migrant worker in Walla Walla fainted while at work. The emergency room physician felt that his nuchal (neck) rigidity (stiffness) was due to a cervical muscle strain. He died a few days after he saw another provider. He had an intracranial hemorrhage due to a ruptured aneurysm. Brain tumors are often associated with headaches, which may be worse in the morning, or with exertion and may be postural (worse when supine). These headaches are typically progressive to the extent of becoming more severe with time and are associated with nausea and vomiting. Clinicians must be able to readily examine the eye through the pupil since papilledema (edema of the optic disk) is usually present. I have seen a few patients with brain tumors whereby vomiting preceded the headache by a few weeks (i.e., posterior fossa brain tumors). Bacterial meningitis in otherwise healthy patients is usually associated with a fever, visual sensitivity to light (photophobia) and nuchal rigidity (reliably tested after 18 months of age). Neisseria meningitidis can cause fulminant meningococcal meningitis. Most cases of meningococcal meningitis are preventable by vaccination. Clinicians must know about other types of headaches the include sinusitis, pseudotumor cerebri, temporal arteritis, glaucoma and malignant hypertension. Malignant hypertension can be associated with papilledema. Neurocysticercosis may present with acute obstructive hydrocephalus Neurocysticercosis or new onset of seizures in patients from Latin America. One patient I had used to experience coital (periorgasmically) headaches. These are either infrequent or patients are too embarrassed to report it. In terms of Ocular Emergencies, clinicians must read about these common emergencies and be ready to diagnose, treat and/or refer such patients. 2007 Luis Lomeli MD


Prior to taking prescription drugs, ask your doctor for advice on all treatment possibilities.
Alcohol, particularly red wine, can be a trigger for some migraine sufferers. It isn't just potentially unpleasant events that produce stress, but the evaluation of your own ability to deal with them. Those are the major reasons generics are much less expensive. Firm muscles, modest amounts of body fat and basic strength are built, in part, by good diet. A balanced stance allows for freedom of movement in any direction and avoids selective tension that can cause spinal misalignment.