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April 22nd, 2010
03:30 PM ET

Migraine relief on the horizon?

By Caitlin Hagan
CNN Medical News associate producer

A cutting-edge treatment for migraines is in the final stages of development and may be on track for regulatory approval within the next few years. Telcagepant, a drug manufactured by the Merck Corp., seems to relieve headache pain without causing vasoconstriction, or the narrowing of blood vessels.


The current class of medications used to treat acute migraine pain causes blood vessels to narrow – vasoconstriction - as a means of relieving the headache. Because of that, the drugs, known as triptans, are not recommended for any patient with a history of coronary heart disease or risk factors such as hypertension.

Telcagepant would be the first safe therapy for migraine suffers who also have risk factors for cardiovascular disease.

"Imagine patients who are 45 or 50 years old who have had a single heart attack in the past so I can't give them anything for their migraines," says Dr. Timothy A. Collins, a neurologist at the Duke University Medical Center who is not affiliated with the development of Telcagepant.

"[This medication] would allow us to treat a previously poorly treated population."

Telcagepant has performed well in clinical trials when used as an acute treatment. But early last year Merck abruptly ended a clinical trial testing Telcagepant as a preventive medication because some trial participants developed liver problems. The company is currently establishing protocols for another safety study that will look at whether there are underlying issues when the drug is taken to relieve pain. The results of that study will determine whether Merck begins the regulatory approval process to get the drug approved for general use. There is no guarantee that Telcagepant will be approved.

Experts agree that if the drug were to be put on the market, it wouldn't replace triptans as a migraine therapy, just add to the list of available medications already on the market.

"For acute therapy of migraine in patients with coronary heart disease, we have anti-inflammatory, we have narcotics - which no one likes to use - and we have older drugs that cause worse vasoconstriction than triptans," says Collins.

"So for there to be a non-narcotic that doesn't cause vasoconstriction, this would be very significant change in the market for what we have to give patients." Collins advises migraine sufferers not to wait for Telcagepant to get approved before making an appointment with their doctor.

"Only half of all people with migraines talk with their doctors and only half of them get prescriptions for their headaches," he says.

"Ask your doctor for something to stop headaches that isn't a narcotic and if you have more than two headachse days a week, talk about migraine headache prevention medication."

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.


April 22nd, 2010
02:39 PM ET

Reader comments about older moms

By John Bonifield
CNN Medical Producer

Today CNN senior medical correspondent Elizabeth Cohen and I wrote about women in their 40s having kids. New CDC numbers say women over 40 are having babies at rates we haven't seen since the 1960s. Younger moms under 40 are actually having fewer babies than previously. One expert we spoke to about this trend told us that whatever can go wrong goes wrong at an increased rate for women who are older and starting a pregnancy.

CNN.com users have been weighing in on this topic. Here's what some of them have been saying.

"The risks are real"

Despite the risks, many users say it's possible for women over 40 to have a health child.

"I had my last child at age 40," one user comments. "There are naturally fewer women having babies after 40, so percentages of babies born may seem higher, but in reality one can still have every bit as healthy a child as a younger person."

Another user writes, "I had my daughter at age 42 (she is now 4) and she turned out just fine. The pregnancy was extremely difficult compared to being pregnant and giving birth to my first child at age 23. The risks are real, but with proper care mother and child can be delivered safely."

"I am a better parent"

There's also been disagreement among users about whether older mothers make better parents than younger moms.

"I think I am a better parent than I would have been in my 20s," one user says. "I do not agree that a couple in their 20s would be better parents. They may be physically stronger or live longer, but will they stay married? Will they feed their kids junk food, mostly because they haven't yet figured out how to eat healthy themselves? Are they emotionally ready to selflessly give up their own lives and make another life the most important?"

Other users say comments like that are a little judgy.

"A person at any age can be a good parent, just as much as they can be a bad parent," one user writes.

"I'm running on fumes"

Some older moms have been weighing in about how much energy it takes to raise their kids.

"The hard part is being 54 like I am now and having a soon-to-be 11-year-old who has boundless energy and goes 24/7. I need to dig deep to the reserve tank when I'm running on fumes in order to be there for him. It's not easy. But I have no regrets," one mom comments.

Another mom says, "We are healthy and active but can be hard to keep up with 2 very active boys."

One mom credits her boys with keeping her young.

"Having to keep up with them, play sports with them...has kept me more fit than most women my age," she says.

"The baby I lost"

Some users are commenting on the heart break over high-risk pregnancies that didn't go well.

"I had a miscarriage at age 40, and though I had a beautiful daughter a year later (she's almost eight now), the baby I lost will always be a sad spot in my heart," she says.


Filed under: Fertility • Parenting • Pregnancy • Women's Health

April 22nd, 2010
01:15 PM ET

What are good non-meat sources of protein?

As a feature of CNNhealth.com, our team of expert doctors will answer readers' questions. Here's a question for Dr. Gupta.

FROM CNN.COM BLOGGER, DAWN:

"What is the most effective way to get extra protein without meat, chicken or fish in my diet?”

Answer:

Dawn,  I can tell you, it is a myth that you need to get all your protein from a meat source. And that rule of thought is something that a lot of people have, so I appreciate you reaching out to me to ask this question. There are many alternatives and ways you can incorporate extra protein in your diet.

First let me explain why it's so important for your health. A diet rich in lean protein is going help build muscle and bone mass that adults start to lose as we age. It is going to help prevent arthritis, and overall it is going to help you maintain healthy skin and organs.

Some of my favorite foods that are high in protein are nuts, soy products and even tofu. Yes, I know many people like to scrunch up their nose when they hear tofu but give it a try! Add it to some stir-fry; add a little sesame oil for some good flavoring. Also, check out the nutrition labels on some of your favorite low-fat dairy products. A cup of cottage cheese has 28 grams of protein; yogurt has 11 grams.

Another question that comes up quite a bit is whether protein shakes are also a good choice. I think they are potentially a good option when it comes to trying to improve your protein stores. However, you want to make sure to examine the ingredient label carefully. Let me give you a couple of quick tidbits when it comes to protein shakes. Look first at the type of protein in the shake. If the source of protein is an animal source (egg whites, whey, milk protein) or a soy protein, it can be considered "high quality" protein. And make sure the type of protein is the first ingredient listed and that it doesn't contain a laundry list of ingredients. The more ingredients, the less real protein it contains. A little rule of thumb to remember is that protein typically has about 4 calories per gram so if you're seeing a lot more than that in a particular shake, you're probably getting a lot of added stuff.

How much per day? Women over age 18 should consume about 46 grams of protein a day; 56 grams per day for men.

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.


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Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.

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