Health: Don't bang your head against a wall to relieve the pain

A Question of Health

I SUFFER from severe, right-sided headaches that come nearly every day for several weeks, and then disappear as quickly as they arrive. Are these migraines, or some other form of headache?

Migraines come in many forms, and your headaches sound like a type of migraine called "cluster headaches". They affect men more commonly than women (unlike ordinary migraines, which are commoner in women). They come, as you describe, in "clusters", and people who suffer from them say they are so severe that they want to bang their heads against the wall to relieve the pain. They often cause watering and redness of the eye on the same side as the headache, and the nose runs.

Once the diagnosis is certain, there are some highly effective drug treatments for cluster headaches. Occasionally, diet can be the reason behind them, with foods such as cheese, chocolate and alcohol being responsible for setting off the headaches, and it is certainly worth avoiding these foods to see if the headaches disappear.

I HAVE developed a horizontal ridge across my fingernails which is slowly moving upwards. What is the cause of this?

A ridge in the fingernail can be caused by anything that interferes with the steady growth of the nail. The most likely thing is a severe physical illness or shock, which prevented the nail from growing for a few days.

Patients who have chemotherapy for cancer, for example, can develop a whole series of parallel ridges in their nails that represent six-weekly courses of their chemotherapy treatment. Fingernails take a couple of months to fully grow out, so the ridges should disappear soon.

I HAVE had some bleeding in the first few weeks of pregnancy, and I am worried that this may have affected the baby. The ultrasound scan is normal. Does bleeding in pregnancy cause abnormalities in babies?

A small amount of bleeding in the early weeks of pregnancy is so common that is can almost be considered normal. Bleeding is often the first sign of an impending miscarriage, but if the pregnancy continues and the ultrasound scan shows that the baby is growing normally, there is no increased risk of abnormalities. Women have traditionally been advised to take to their bed if they are bleeding in early pregnancy, but this has not been proved to be of any benefit to either mother or baby.

I AM developing cataracts and I fear that I will have to be blind before they are operated on. Do I have to wait for the cataracts to get severe before they can be removed?

Cataracts, which are caused by the lens of the eye becoming more and more opaque, can be removed at any time. It is not necessary to wait until they "ripen" before having them removed. The most sensible time to remove them is when they are significantly interfering with everyday vision. There is no point in waiting until you are partially or totally blind. The usual reason for delays in removing cataracts is NHS waiting lists, and it rarely has anything to do with medical necessity.

Write to: A Question of Health, `The Independent', 1 Canada Square, Canary Wharf, London E14 5DL; fax 0171-293 2182; or e-mail to health@independent.co.uk. Dr Kavalier cannot respond personally to questions