Accurate blood tests mean more groups can give blood safely, experts say.
The company initially said it didn’t want to “incentivise inappropriate use” of the pill.
The world of medical schemes is a complicated one – and there are many myths and misconceptions doing the rounds. Below is the truth about some of these.
Myth: Medical schemes make a profit.
Fact: Medical schemes as such are not profit-making organisations. They might be part of bigger insurance companies, which do make a profit, but there are different laws governing insurance products and medical schemes. If a scheme registers a profit, it goes into the reserves of the scheme, and this belongs to the members. Medical schemes have trustees, not shareholders. Of the registered open medical schemes in SA, only 8 of the 23 achieved an operating surplus in 2015.
Myth: A scheme can refuse my application.
Fact. No it cannot. A scheme can make you pay a late-joiner penalty, and impose a general waiting period of three months or a condition-specific waiting period of no more than 12 months on a new member. But it cannot refuse your application if you can pay the membership contribution.
Myth: Medical inflation is higher in SA than elsewhere.
Fact: Medical inflation is a worldwide phenomenon. In SA, medical inflation, on average, has been 2% above CPI inflation over the last 16 years. High equipment and medication costs, the spiralling costs of private healthcare, overtreatment in the private sector, and the increase in lifestyle-related diseases all contribute to high medical inflation worldwide.
Myth: Medical insurance is the same as a medical scheme.
Fact: Medical insurance is not covered by the Medical Schemes Act, and functions more like an income-replacement product than medical cover. A medical insurance product pays you out for certain diagnoses, or a hospital stay – it does not pay your medical bills.
Myth: If my scheme gives 100% cover means I don’t have to pay in anything.
Fact: Not true. Schemes can cover you for 100% of the medical fund tariff, which may be considerably lower than the cost of the private hospital or private doctor. You could end up with a big co-payment.
Myth: A scheme can force me to use network hospitals.
Fact: No, it can’t. It can encourage you to do so by guaranteeing no co-payments from your pocket if you stay within the network. If you choose to use out-of-network hospitals or doctors (except in certain emergencies), the scheme can make you pay the difference, but they can’t force you to use certain healthcare services.
Myth: Pensioners pay a lower membership contribution.
Fact: No, that is not allowed. In many other spheres of life pensioners get a discount, but not for medical scheme contributions. In fact, it is illegal to let pensioners pay less. Traditionally pensioners are also high claimers on most medical schemes.
Myth: My employer has to subsidise my scheme contributions.
Fact: No, they don’t. The employer can, as part of your employment contract, require you to belong to a certain scheme, but they do not have to subsidise your contributions. If you work for the state, you might be lucky in getting a third of your contribution subsidised, but it is a privilege, not a right.
Myth: I cannot put my parents on my medical scheme.
Fact: If they are financially dependent on you, and you can prove it, they can join as adult dependants on your scheme.
Myth: A scheme can tell me which medication to use.
Fact: They can encourage you to use the medication on their medicines formulary. If you choose not to, you might have to pay the difference in cost, but they cannot force you to take a particular type of medication.
Myth: A scheme can exclude me from treatment for a pre-existing condition forever.
Fact: No, they can’t. They can only impose a 12-month waiting period for a pre-existing condition. If however, they find out that you did not disclose a pre-existing condition, you can be found guilty of fraudulent behaviour, and there might be penalties imposed because of that.
Myth: A hospital plan will only pay for in-hospital treatment.
Fact: Generally, yes, but all hospital plans also have to pay for the treatment of 25 chronic conditions. You might also be entitled to claiming for six-monthly GP visits to have your chronic prescriptions renewed.
Myth: I can change options whenever it suits me.
Fact. You can usually only switch options once a year in January on most schemes. This is done to streamline administration of things such as savings accounts, which are allocated on an annual basis. Nothing stops you from changing options every year.
Myth: A medical scheme cannot terminate my membership.
Fact: They can, if you are unable to pay the monthly contributions, or if you are found guilty of making fraudulent claims.
Myth: Complications from elective surgery are for my own account.
Fact: If you have cosmetic surgery, for which the medical scheme will not pay, and you get septicaemia after the operation, they will pay for the treatment of the infection, as that is a prescribed minimum benefit.
Myth: Once my benefits run out, that’s it for the year.
Fact: Even if your savings account is depleted, you are still covered for in-hospital treatment. You can also apply to your scheme for further ex-gratia payments for day-to-day treatment. These are evaluated on a case-by-case basis, according to certain protocols.
Myth: All cancer treatment is a prescribed minimum benefit.
Fact: Some cancers are PMBs, but certain cancers, when advanced, are not deemed treatable. Depending on your scheme, you can still claim for these from your oncology benefit, though. After this, many schemes will expect you to pay a portion of your treatment yourself – this depends on your scheme and the option you have chosen.
Myth: I cannot claim anything during the three-month waiting period.
Fact: You couldn’t buy a new pair of spectacles, but if you were in an accident, you could definitely get treatment at the nearest trauma unit.
Myth: Schemes take forever to settle claims, especially big ones.
Fact: The scheme has 30 days from receipt of the claim (with all the relevant information) to settle it. The only delays will be if there is information missing. You usually have until the end of the fourth month from the last date of your treatment to hand in claims. If schemes regularly miss the 30-day payment schedule, they are called to account by the Council for Medical Schemes.
Myth: The money in the savings account is yours.
Fact: It is yours in that it can only be used by you to pay for your medical expenses. But you cannot draw the money out in cash, or use it to settle the bill for co-payments. This money is carried over from year to year if you do not use the full allocation. It will only be paid out to you four months after you have left the scheme.
All images provided by iStock
(Sources: The Council for Medical Schemes; Alexander Forbes Health)
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Somehow the most nonthreatening body problems almost always turn out to be the most frustrating. Sure, your cramps, stress headaches or yeast infections aren't going to kill you, but man, what a hassle! Wouldn't it be nice to solve them yourself, once and for all? Well, you can, with the right know-how: "Conventional medicine has a solid track record for serious issues, but natural cures can be a great way to ease those day-to-day annoyances," says Mao Shing Ni (known as Dr. Mao), PhD, a doctor of Chinese medicine and author of Secrets of Longevity Cookbook. "Plus, in many cases, the risk of adverse reactions is much lower, and the ingredients may already be in your home." Next time one of the following minor maladies messes with your life, look to some alternative remedies, along with dietary tweaks that can make all the difference.
You've got: A stress headache
What causes it: When you get really frazzled, the muscles in your head and neck tend to tense up, which constricts blood flow and can bring on the distinct throb of a stress headache. It's generally felt all over, like a dull but distracting ache, versus a migraine's one-sided pounding.
Eat this: Foods containing magnesium, such as spinach, nuts, Swiss chard and beans. "I call magnesium the relaxation mineral," says Mark Hyman, MD, a functional-medicine specialist and author of The Blood Sugar Solution 10-Day Detox Diet. "It pulls calcium out of muscle cells, which helps the muscle relax." Running low on magnesium (which most of us are, Dr. Hyman says) can lead to constantly tense muscles because the calcium is locked in. It's best to eat your magnesium, but supplements are an option. Women 30 and under need 310 milligrams daily. Over 30? Go for 320mg. In the meantime, avoid refined sugar, which can cause big spikes and crashes in blood sugarÂ—a recipe for a skull throbber. Instead, satisfy your sweet tooth with fruit.
Do this: Put your thumb on the back of your neck at the base of your skull, and look up so you're creating firm, steady pressure. "There's an acupressure point here that's connected to the muscles that tend to tense up," Dr. Mao explains. "While you're pressing into it, breathe in as you count to five, then breathe out, counting to 10." Perform this breathing exercise while holding the point for five minutes and the pain should dissipate. And "if possible, take a 15-minute break from the stressful environment that led to the headache and go somewhere dark and quiet to relax," adds Draion M. Burch, DO, an ob-gyn at the University of Pittsburgh Magee-Womens Hospital. "Take deep breaths or turn on soothing music. When you relax, your muscles will too."
You've got: A recurring yeast infection
What causes it: While pretty much every woman can count on experiencing the redness, intense itching and thick, white discharge of a vaginal yeast infection at some point, the worst is one that just keeps coming back, striking at least four times a year. If you've tried over-the-counter creams or prescription antifungals and you're still itching, that's a sign you may have a resistant strain of candida, the fungus that causes yeast infections.
Eat this: A daily 6- to 8-ounce container of plain yogurt (if you're lactose intolerant, soy or coconut yogurt works). Make sure it contains Lactobacillus acidophilus, a probiotic (good bacteria) that helps create an unfriendly environment in the vagina so yeast doesn't grow out of control, Burch says. It's very important to check that the yogurt has no added sugar, since yeast thrives on the sweet stuff, Burch adds. Other healthy whole foods, like lean proteins, leafy and cruciferous greens and healthy fats, along with garlic and coconut oil, also have anti-yeast properties, Dr. Hyman says.
Do this: Try a vaginal suppository with boric acid powder. Yep, you know boric acid as a bug killer, but hear us out. "Ob-gyns used to prescribe boric acid to women all the time before over-the-counter creams and the one-day prescription pill appeared," explains Tieraona Low Dog, MD, a specialist in natural remedies and author of Healthy at Home. "It's effective against the less common species of the fungus, which don't always respond to conventional treatment." If you want to try it, "you can buy boric acid powder, not crystals, in any pharmacy, then place it in size 0 or 00 capsules, sold at drugstores, and insert one into the vagina each night for a week," Dr. Low Dog says. Don't take the capsules by mouth (they're toxic if ingested), and don't use them at all if you're pregnant.
And FYI: Chronic yeast infections can be an early sign of diabetes. See your doc if you have symptoms such as frequent urination.
You've got: A runny nose
What causes it: When a cold virus or allergen invades your nasal passages, your body releases chemicals called histamines that increase mucus production and cause other symptoms, like itchy eyes or sneezing.
Eat this: Fermented foods, such as yogurt, miso or sauerkraut. They contain probiotics that can help boost immunity so you're armed against colds and flu. If you're already congested, you might want to avoid dairy products (they can make symptoms more noticeable) and sweets, which can crank up mucus production. Sometimes a runny nose is a reaction to a food allergen, like dairy or gluten (a protein in wheat rye and barley). "If your symptoms persist, consider being tested," Dr. Mao says.
Do this: Disinfect a small squirt bottle by dipping it in boiling water. Then, after the water has bubbled for at least a minute, let it cool and add it to the bottle with 1 or 2 teaspoons of table salt. Shoot a tiny amount into your nasal passage before blowing it out gently, Dr. Mao suggests. (Sounds unpleasant, but we promise it's not bad.) Besides rinsing out allergens and other germs, salt water is a natural antimicrobial that helps fight the bacteria and viruses that caused the cold in the first place. It can also dry up excess mucus. Don't have a squirt bottle? A neti pot will work the same way, or you can try a premade salt spray like Simply Saline. Both are available in drugstores.
You've got: Constipation
What causes it: Often it's a change in your routineÂ—you go on a big trip or have a superbusy few weeks that keep you out of the gymÂ—that disrupts your regular bowel habits, making you feel backed up and bloated. And the longer things remain standing still, the worse constipation can get.
Eat this: Down an 8-ounce glass of unfiltered aloe vera juice with 2 ounces of unfiltered apple juice. "Apple juice has pectin, which is fibrous, and the aloe vera speeds digestion," Dr. Mao says. Another option: a tablespoon of hemp seed oil or flaxseed oil before bed, which lubricates the digestive tract, he says. If you're often constipated, it might be a good idea to consider a daily regimen: Take 2 tablespoons of ground flaxseeds every morning (you can add them to your yogurt or mix them into green juice), pop 150 to 300mg of magnesium citrate in capsule form at breakfast and lunch and drink at least eight glasses of water throughout the day. "Flaxseed is an excellent source of fiber and omega-3 fatty acids, which are good for reducing gut inflammation; water helps move things through," Dr. Hyman says. "Magnesium citrate helps relax the bowels so you can go."
Do this: "Lie flat and massage your lower abdomen with your fingertips in short up-and-down motions for a few minutes every hour to help get things moving," Burch says. Afterward, walk around for a few minutes and have a full glass of water.
Are you chronically stopped up? See your doc for a thyroid check; a sluggish thyroid gland can cause constipation as well as other health issues, like weight gain and fatigue, Dr. Hyman adds.
You've got: Menstrual cramps
What causes them: When it's time for your period, your body ramps up production of prostaglandins, hormone-like chemicals that help expel the uterine lining by causing contractionsÂ—and, unfortunately, triggering inflammation and those familiar pains in your belly. Over-the-counter pain meds are the usual go-to, but if you take them too often, they can lead to side effects such as upset stomach and diarrhea.
Eat this: Ginger is an antispasmodic that helps block prostaglandins. Sip ginger tea (you can buy tea bags or steep grated fresh ginger root) at the first twinge of cramps so you stop them before they get really intense, Dr. Low Dog says. Foods with omega-3s, like walnuts, pumpkin seeds and fatty fish (salmon, sardines) can also help reduce cramps over time. Omega-3s have anti-inflammatory powers that help slow prostaglandin production. "Up your consumption of cold-water fish to 3 to 4 ounces twice a week, or take a daily fish oil supplement that offers 500 to 800mg of EPA or 200 to 500mg of DHA. You'll see improvement in your cramps in three months," Dr. Low Dog says.
Do this: Massage a pressure point at the end of your spine (about 2 inches above your butt). "The nerves here connect to the uterus, so applying constant pressure to this spot with your palm or fingertip relaxes the uterine muscles," Burch says. You can reach back and do it yourself or ask your partner to help.
You've got: Canker sores
What causes them: These shallow, painful sores tend to strike because of some kind of irritation, like after you've bitten your tongue. They also appear when you're stressed. Most of the time the exact cause is unclear, but they're unrelated to cold sores (which are brought on by a virus).
Eat this: Yogurt. Swishing a spoonful of the plain, sugar-free kind along your gums helps rebalance the microbes in your mouth so it's a less favorable place for the harmful germs that can irritate the sore and make it worse, Dr. Low Dog says. Skip spicy or acidic foods, such as citrus or sodas, which can exacerbate an existing canker sore and may even cause new ones to form, Dr. Mao explains.
Do this: Gargle with a 50/50 solution of hydrogen peroxide and water three times a day and right before bed. Hydrogen peroxide is an antiseptic that can kill those bacteria, Dr. Mao says. "If the sore is already irritated, coat it with baking powder before bed, which helps it close up faster." Canker sores can also be a sign of celiac disease or gluten sensitivity, Dr. Mao notes, so consider being tested if you get them frequently or if you have symptoms such as abdominal pain.
You've got: Itchy winter skin
What causes it: Your skin just can't win in the colder months. Both the heated indoor air and the dry, chilly air outside mean you're facing dehydrated, flaky skin no matter what. And it's hard to resist scratching itÂ—which only contributes to the irritation.
Eat this: Foods high in B vitamins, such as poultry, meat and whole grains. "B vitamins, especially niacin (or B[subscript 3], found in poultry, meat and fish), help open capillaries near the skin's surface, improving delivery of blood and boosting skin health," Dr. Mao says. Avoid refined sugar: "Sugary, processed foods worsen skin issues because they immediately raise blood sugar levels, triggering an insulin response that leads to puffiness, itching and dryness," Dr. Hyman says.
RELATED: 15 Natural Back Pain Remedies
Do this: Moisturize skin with natural nut or vegetable oils, available at supermarkets and organic food stores. "Walnut, coconut, hemp seed and avocado oils are high in specific amino acids that help your skin rehydrate," Dr. Mao says. (One quick note of caution: If you or someone in your family has a tree nut allergy, skip oils made with those; there is a potential for a reaction when used on skin, Dr. Mao adds.) You can apply it directly to skin as needed. Or, for a hydrating treat, replace your nightly shower with a relaxing bath. Add 2 tablespoons of your favorite oil to the warm water and climb in. Afterward your flaky skin (and your stress) will be gone for sure.
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Signs you definitely need to see your doc:
Sometimes an appointment is best: If you develop one of these startling symptoms, skip the home remedies and go right to your MD to have it checked out.
Shortness of breath: Any breathing trouble needs medical attention. It may be asthma, which can be controlled with steroids. If it's sudden with chest pain, it could be a pulmonary embolism, i.e., a blood clot in your lungs. If you suspect that, get to the ER.
Dizziness or fainting: Either symptom can have a host of causes, from stress to more serious things, such as a heart condition like atrial fibrillation. To sleuth out the problem and stop your head from spinning, you need a professional opinion.
A wound that swells and oozes: A cut or gash that gets red, puffy and painful and has discharge or pus coming from it indicates you probably have an infection, meaning it won't get better without a dose (or two) of prescription antibiotics.
RELATED: Home Remedies Doctors Swear By
A superhigh fever: At the first sign of heat, pop an anti-inflammatory like acetaminophen. Tell your doc if your fever reaches 103Â°. If it lasts longer than 24 hours, get to an ER or urgent care center. You may be fighting a potentially life-threatening infection.
Slash the sugar, save your health?
Experts have long given refined sugar the side eye, blaming it over the years for tooth decay and weight gain. But now holistic physicians as well as many traditional docs are arguing that the sweet stuff is an even bigger health threat. Here's why: Added sugar (the kind not present naturally in certain foods, like fruit) immediately spikes your blood glucose levels, resulting in elevated insulin levels. "High insulin paves the way for diabetes," Dr. Hyman explains, "and it also leads to low-grade inflammationÂ—an immune system response to what your body mistakenly believes are foreign substances that need to be attacked." Over time, inflammation can aggravate headaches, damage blood vessels and otherwise wreak havoc throughout your body. Cut your sugar intake and you'll reduce inflammation, potentially improving everything from your skin to your cholesterol numbers.
Three natural cures to skip:
For every earthy remedy that works, there are at least a few more that have been proved useless. And after all, no one wants to waste time and money. Here's the scoop on nonmedical tactics you should ignore.
Oil pulling for cavities: This Ayurvedic practiceÂ—where you swish a tablespoon of oil (coconut, sesame, sunflower) around in your mouth for up to 20 minutesÂ—is said to whiten teeth and prevent cavities. While a few small studies show it may help reduce mouth bacteria as well as regular mouthwash, you'll still need to brush, floss and schedule your routine dental visits. Why add a step?
Candling for congestion: You hear this treatment sucks out earwax, impurities and even congestion from a cold, but research reveals that the candle doesn't create a suction effect. Even if it did, the mechanics of your ears and sinuses makes it impossible for things to be simply pulled out. What is possible from candling? Burns or a punctured ear drum. No, thanks.
Black cohosh for hot flashes: This herb supplement was once a promising candidate for easing hot flashes. But sadly, the research on its effectiveness is conflicting, and it hasn't passed muster in larger, controlled trials. You're better off trying meditation or other relaxation techniques to control stress, which has been linked to making hot flashes harder to handle.
The toe bone's connected to the foot bone… That childhood ditty left out more than a few crucial parts: Adults are held up by a skeleton composed of 206 bones that protect the body's vital organs. Though it's a sturdy frame, it's vulnerable to problemsthink issues like osteoporosis and stress fractures, says Chad Deal, MD, director of the Center for Osteoporosis and Metabolic Health at the Cleveland Clinic. But if you bolster your bones now, it will pay off for years to come, keeping you on your feet and feeling great whether you're running errands or marathons.
Bone-builder No. 1: The right diet
GET LOTS OF…
Milk: The recommended daily value of calcium is 1,000 milligrams (1,200 if you're over 50); a cup of nonfat or 1 percent milk has 311. Yes, foods like greens and fish provide calcium, but stick to the white stuff to really boost bone: "There have been so many studies linking dairy to bone health," Dr. Deal says.
Dark leafy greens: They contain not just calcium (a cup of cooked kale has 94mg) but also hefty doses of vitamin K, which may help increase bone-mineral density. Get 90 to 120 micrograms of K daily (that cup of cooked kale has over 1,000).
Sardines: Their little crunchy bones are why a 3.75-ounce can holds about 351mg of calcium. They also pack 250 IU of bone-aiding vitamin Dtry to get 600 IU daily.
RELATED: 11 Foods for Healthy Bones
STEER CLEAR OF TOO MUCH…
Salt: Ingesting excess sodium can make the body lose calciumand bone. Aim for 2,300mg or less a day.
Booze: While research has found that women who drink one to two servings of alcohol a day have higher bone density than teetotalers, downing more than two servings a day may actually speed up bone loss.
Caffeine: Drinking more than three cups of coffee every day may interfere with calcium absorption, and some studies suggest that having cola at all is associated with bone loss, though the reasons why aren't yet clear.
Bone-builder No. 2: Calcium is key
Do you need a calcium pill? It depends. "If you're eating three or more servings of dairy a day, you're likely getting close to the recommended 1,000mg from your diet, which is really the preferred way, since calcium is most easily absorbed by your body through food," Dr. Singer says. But if you're not, which is probably true if you're lactose intolerant, vegan or over 50, consider taking a supplement. Since the mineral is best absorbed in doses of 600mg or less, divide your 1,000 to 1,200mg into two pills; take one in the morning and the other at night.
RELATED: 10 Healthy Calcium-Packed Recipes
Look for supps that contain vitamin D, too. While studies conflict when it comes to the benefits of taking D alone, experts agree that when paired with calcium, it's a no-brainer for bone health: "You need D to help pull in calcium," Dr. Deal says. A combination pill with up to 600mg of calcium and 400 IU of D, taken twice daily, should help most women. Talk to your doc if you're unsure about your dosage.
Bone-builder No. 3: Moving it
"Putting stress on bones"like by pounding the treadmill or hoisting kettlebells"forces them to make new cells, building their density," explains Cedric Bryant, PhD, chief science officer of the American Council on Exercise. Here's what to do, and how often.
Weight-bearing exercise: The more body weight you put against your bones, the better, which is why relatively high-impact activities (like jogging and jumping rope) are ideal. Do half an hour most days, if possibleyou can split it up into shorter bursts. If you're out of shape or getting over an injury, a lower-impact workout, such as walking, is fine. While no-impact activities like swimming and biking are great for your heart and muscle, they provide only modest benefits to your skeleton.
Resistance training: Two or three days a week, either lift dumbbells or work with your own body weight (think squats and lunges).
Balance exercises (Yoga, Pilates, Tai Chi): Squeeze these in whenever you can: They improve your stability, so you're less likely to fall and break a bone.
Bone-building workouts ranked from most effective to least effective:
Aerobic dancing (like Zumba)
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Bone-builder No. 4: Estrogen power
In your 20s and 30s The estrogen coursing through your veins helps moderate bone growth. "When women are getting regular periods, their estrogen levels are normal, and their bodies are constantly remodeling bone, meaning there's no net loss," says Bismruta Misra, MD, director of Fairfield County Diabetes and Endocrinology at Stamford Hospital in Connecticut. That is, except for when you're pregnant or nursing: Since any nutrients you consume nourish your wee one first, you must eat well to minimize the expected bone loss and regain bone density.
In your 40s and 50s Within five or so years of menopause, when estrogen levels start to drop, women can lose up to 20 percent of their bone density. MDs used to recommend starting the pill or hormone therapy as protection, but research doesn't support doing this. Instead, keep exercising and getting 1,200mg of calciumfrom food as much as possible to avoid problems like kidney stones.
RELATED: 17 Ways to Fight Osteoporosis
Could you have osteopenia?
This conditionwhich affects about half of all adults over age 50 but can be detected as early as age 30is simply low bone-mineral density that's not quite low enough to qualify as osteoporosis. Though osteopenia can raise your risk of fractures, it's often symptomless, so the only way to know if you have it is to get a DXA scan (usually covered by insurance) to measure the actual density of your bone. A so-called T-score between -1.1 and -2.5 means you have osteopenia.
RELATED: 5 Medical Tests to Think Twice About
Most mild cases can be treated with lifestyle modifications such as better diet and exercise; more severe cases may require meds. The National Osteoporosis Foundation (NOF) recommends that all women have a baseline scan at age 65. It also suggests one for postmenopausal women under 65 who have at least one risk factor. ("Most do," Dr. Deal says.) If you've got any of those listed at right, talk to your doc about getting screened soon after menopause.
10 risk factors for osteopenia
You're underweight (your BMI is under 18.5).
You get less than 1,000mg of calcium daily.
You smoke or are a former smoker.
You're a couch potato.
You have a history of eating disorders.
You've got a family history of osteoporosis.
You have more than two alcoholic drinks a day.
You went through menopause before 40.
You've got an autoimmune disorder (like RA or lupus), celiac disease, inflammatory bowel disease, diabetes or hyperthyroidism.
You take steroid medications.
That's the number of bones humans have in one foot; each of our hands contains 27. together they account for more than half the bones in our skeleton.
How we build bone
They may appear rock-hard, but bones are living tissue made mostly of collagen, a protein that keeps them flexible, and calcium phosphate, a mineral that gives them strength (which is why consuming calcium is so crucial). They constantly break down and rebuild themselves in a process called remodeling. "First, cells known as osteoclasts remove old, weakened bone," explains Andrea Singer, MD, clinical director of the NOF. "Then osteoblast cells lay down new tissue." During adolescence, new bone is added more quickly than the old stuff is removed. By age 25 or so, you reach peak mass; after menopause, old bone gets removed faster than new bone is built, which can lead to osteoporosis.
Shin splints: What a pain
Prone to shin splints (pain in your shinbone)? Your best recovery strategy is rest and icing your tibia (shin) for a few days, then switching to a no-impact activity (say, stationary biking) for a week. If the pain persists or returns, see your doc. He may recommend physical therapy, after ruling out a more serious problem like a fracture. Prevent splints by changing your sneakers every six months and doing toe raises regularly.
Fractures are any kind of break in a bone; stress fractures, specifically, are cracks most often caused by overdoing an activity. "Just touching one can send you through the roof, screaming in pain," says Steve Hawkins, PhD, professor of exercise science at California Lutheran University. If you think you have a stress fracture, see your doctor. While it may not show up on an X-ray for 10 to 14 days, an MRI can spot one earlier. Treatment is physical therapy and possibly a brace or cast to keep weight off the area while it heals, which usually takes six to eight weeks.
First aid for breaks
If you suspect that you or someone you're with has broken a bone, follow these four steps if you can, then head to the ER.
1. Stop any bleeding. Make a tourniquet with a sterile bandage or clean cloth and tie it above the fracture.
2. Immobilize the injured area. Don't try to realign the bone or push one that's sticking out back in. If possible, protect it by creating a makeshift splint: Place rolled-up newspaper or strips of wood along the limb, then tie them on with a belt or fabric.
3. Wrap ice in a towel and apply to the area to reduce pain and inflammation.
4. If you feel faint, lie down with your head slightly lower than your torso.
The blues and your bones
Women who suffer from major depression tend to have lower bone density than women who don't, possibly because depressed women secrete higher levels of hormones, such as cortisol, that break down bone. Thankfully, many first-line treatments for anxiety and depressionexercising, maintaining a healthy dietalso work to boost bone.
Just a sip of cabernet, a whiff of cigarette smoke, a flickering fluorescent light or a sudden rainstorm can be enough to send many women straight home to bed for hours or days with throbbing, debilitating pain.
Although migraines are the most common severe headache disorder, afflicting some 27 million American women, researchers still don't fully understand what causes themor how to make them completely stop. "Preventive medications help 50 percent of patients by about 50 percent," says Sheena Aurora, MD, of Stanford University's headache program. Even if the drugs work like magicwhich they do for many migraine sufferersoveruse of certain pills (particularly barbiturates, triptans and opiates) can cause rebound headaches.
To land on the right remedy, sufferers usually slog through a process of trial and error, and it often takes more than one type of treatment to find relief. "We really don't know why some things work for some people and not others," admits neurologist Jack Schim, MD, co-director of the Headache Center of Southern California. "There are enormous genetic differences from person to person, which may affect how we absorb and metabolize medications." That's where alternative therapies come inwhich can be used in tandem with drugs or by themselvesas part of a migraine-relief plan.
Here are three of the most promising less traditional remedies, with feedback from both headache specialists and women who've used them to contain the pain.
The fix: A migraine-fighting gizmo
Imagine if you could wear a band across your forehead that electrically stimulated the trigeminal nerve, heading off migraine attacks. Sounds like sci-fi, but an FDA-approved device called Cefaly does just that. You wear it at home for 20 minutes a day, even if you aren't having a migraine. In a study published in the journal Neurology last year, Cefaly was shown to reduce monthly migraine days by 30 percent.
The tester says
"I started having migraines at 16. I got three to five a week, especially around my period. I've seen pain specialists, headache specialists and neurologists. I've been hospitalized. I tried all the different medications, and my headaches just became worse.
Five or six years ago, my neurologist put me on preventive migraine medication. It worked a little, but the side effects were terrible: I forgot things; I thought I had dementia. I would be driving in my own neighborhood and not remember how to get where I was going. I'd just pull over and cry.
When my dad forwarded me an article about Cefaly, I immediately got a prescription from my pain specialist and bought the device, which looked really space-agey. The day it was delivered, I started to get a migraine. I put it on, and the migraine never fully developed. In the four months I've been using CefalyI relax with it at night before bedI've had only two migraines, and they were less intense than I'm used to. I do have some sinus issues, and I still get a small aura (where I see flashes of light) in the morning, but that has gotten less severe, too. Overall, I no longer have pain and brain fog all the time!" Tracey Goodman, San Diego
The expert verdict
It's worth a try for anyone who "doesn't want to take medication and is interested in something techy," Dr. Aurora says. Although Cefaly hasn't yet been tested on pregnant women, experts believe that it is safe for them. (Most migraine medications are classified as schedule C, which means it's unknown whether they're OK to use during pregnancy.) She notes that those who have success with the device typically notice an improvement in about a month, and some people see a dramatic change.
You'll need a prescription to get your hands on the device, so talk to a doctor, ideally a neurologist or headache specialist, if you want to go the tech route. (There's also another headache-easing gizmo coming to the market soonsee Zap Away the Pain, above.) Cefaly costs around $325, and at this point most insurance companies don't cover it; order the gadget at cefaly.us.
The fix: Elimination diet
Turns out, certain foods activate an inflammation response that triggers migraines in people who are prone to them. Top offenders include red wine, aged cheese, cured meats (like hot dogs and cold cuts), monosodium glutamate (MSG), dairy, artificial sweeteners, chocolate and gluten. Typically, headache clinics recommend cutting out these foods for six weeks, then adding them back in individually to see if any bring on your head pain.
The tester says
"My migraines were bad since age 10. By the time I was in high school, I was getting them constantlyoften for weeks. I missed almost half of my junior and senior years, going in and out of the hospital. Getting acupuncture regularly and changing my medication improved things in college, but during law school, my headaches kicked in again.
I mentioned to a friend that I often had stomachaches after I ate, and she said, 'That's not normal.' I started researching to see if my stomach problems and migraines were related and found articles about celiac disease. I was shocked to see how many of the symptoms I had and to learn about the link between migraines and gluten for many people with celiac disease.
I decided to try going gluten-free on my own, and within a few weeks not only did my stomachaches disappear but my migraines let up, too. But I found it hard to believe that gluten had been causing so many problems for so long, and one night I foolishly decided to eat gluten to see what would happen. I ordered pizza and, sure enough, had a terrible stomachache and the beginnings of a migraine within 30 minutes of eating it.
Eliminating gluten from my diet was life-changing. Although I haven't been formally diagnosed with celiac disease, I know how important it is for me to avoid gluten. I've learned my lesson, and I don't cheat at allit's not worth it!" Stephanie T., Chicago
The expert verdict
"If a food is a problem, you're going to figure that out pretty quickly if you try an elimination diet," says Merle Diamond, MD, managing director of the Diamond Headache Clinic in Chicago and clinical assistant professor in the department of medicine at Rosalind Franklin University of Medicine and Science. And there's good evidence that gluten can be a culprita 2013 study from Columbia University found that people with celiac disease suffered from more migraines than those without it.
Perhaps the biggest food suspect, however, is tyramine, a compound that occurs naturally in aged and fermented foods, including cured meats, aged cheese, smoked fish and some beer. A 2010 study of migraine sufferers said hot dogs and cheese were among the most common culprits, and Dr. Diamond has seen great results with low-tyramine diets. Not all migraine sufferers have food sensitivities, but for those who do, eliminating a problem food can cut headaches by 50 to 60 percent. "Within a month," she says, "it has changed people's lives."
To test for food triggers, it's best to work with a doctor. Insurance will cover a visit to an MD to talk about recommended dietary tweaks as part of your medical care. Reach out to a migraine and headache specialist (visit americanheadachesociety.org or headaches.org to find one), as not all neurologists specialize in migraine treatment.
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The fix: Botox injections
The same toxin that relaxes facial muscles to smooth wrinkles can also dull the transmission of pain messages to the brain. In a 2010 study, Botox injections (to seven key areas on the head and necka total of 31 jabs) cut migraine headache days in half within six months for about 50 percent of those treated.
The tester says
"The first time I got a migraine, when I was 17, I freaked out because I thought I was having a stroke. I was nauseous and vomiting, and I had these black flashes in my eyes, like pictures were being takenin other words, an aura. I ended up getting triptans, which helped for about two years. Then in college, I started having migraines all the time: For two weeks each month I couldn't do anything but lie in a dark room. At one point I was hospitalized; it was a nightmare. On top of that, the MDs put me on this other medication that made me feel totally wacked-out, like I was high. I had to stop taking them.
My mother, who also suffers from migraines, suggested Botox. She was getting the treatment and it was really helping, so I went to see her neurologist. I'll admit: I was a little leery about the needles, but at that point I was desperate. I felt like I was becoming an invalid.
The injections didn't hurt that muchkind of like getting your eyebrows tweezedthough I did have some neck stiffness. After about a week and a half, I noticed that I was getting fewer auras, and then I didn't have a migraine at all for three to four months. The Botox started wearing off after that (each treatment lasts for about three months), and the migraines came back. I was having a full-on migraine during the second treatment, and it lifted after a week and a half.
It's been a year since my last treatment. As far as going back for more, the doctor told me to feel it out. But I haven't been getting severe migraines, and maybe that's thanks to the Botox. I've heard the effects can improve over time with repeated treatmentswhatever the reason, I'm grateful to be feeling better." Hannah Campbell, New York City
The expert verdict
"I've been injecting Botox for difficult-to-treat medical conditions for 25 years, since it was first approved for rare eye-muscle disorders in 1989," Dr. Schim says. "For treatment of chronic migraine, I've seen some real home runs." A number of patients notice a benefit within a week or two; others need two or three treatments. What's more, he adds, results can improve over time for many patients, as likely happened with Hannah. But take note: There can be potential side effects with Botox, like bruising or neck pain.
Go to a neurologist who is board-certified in headache treatment (again, americanheadachesociety.org and headaches.org are good search tools). Insurance should cover Botox for chronic migraine, which is defined as 15 or more headache days a month. With any luck, your migraine days will soon be numbered.
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NHS England says 18 treatments – including homeopathy – should generally not be prescribed.
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