By Joe Graedon, M.S., and Teresa Graedon, Ph.D. The People's Pharmacy
Q. I have had chronic migraines for over 18 years. To treat them, I have used most of the triptan migraine meds with varying degrees of success, along with Botox, Cambria and injectable Imitrex.
I was switched to Aimovig recently. My doctor prescribed two self-injected shots every month. I also started ketamine. Now I am almost completely free of migraines.
A. Thank you for sharing your long and challenging pain path with migraine headaches. Aimovig (erenumab) is a self-injectable subcutaneous preventive treatment. It was first approved by the FDA in 2018 and can reduce the number of migraines in a month.
A Danish study in the journal Brain Communications (April 15, 2025) reports that there is considerable variability in response to this drug. About half of the participants got benefit.
Ketamine is a very controversial drug. The FDA has only approved it as an anesthetic. Doctors are prescribing it off-label for a number of other conditions, including chronic migraine headaches and treatment-resistant depression. Italian researchers reported that intranasal ketamine could provide quick-acting migraine pain relief in the emergency department (Medicina, Sept. 29, 2023).
You will find more information on managing migraine pain in our eGuide to Headaches & Migraines. This online resource is located under the Health eGuides tab at www.PeoplesPharmacy.com.
Q. Anyone having difficulty getting their doctor or insurance company to approve an Lp(a) blood test should be aware of several options to bypass those obstacles. A few web sites can be used to order this test and numerous other blood tests, with the person ordering the test paying out of pocket. One such web site is LifeExtension.com, which charges $39 for a test. You get a lab order you can take to a LabCorp or Quest Diagnostics office.
A. Lipoprotein(a) [Lp(a)] is a significant risk factor for atherosclerosis and heart disease. It is estimated that one in five Americans has elevated levels of Lp(a), but only about one percent has been tested (New England Journal of Medicine, May 1, 2025).
You are correct that several websites offer consumers the option of ordering a test. In addition to LifeExtension.com, PrivateMDLabs.com and HealthLabs.com offer such tests. You can also order directly from Quest Diagnostics or Labcorp On Demand (ondemand.labcorp.com).
The ALPACA trial showed that the experimental drug lepodisiran can lower this blood lipid dramatically, by 40 to 90 percent, depending on dose (New England Journal of Medicine, May 1, 2025).
We don't yet know whether lepodisiran or similar medications will be able to prevent heart attacks and strokes or aortic stenosis.
Q. I recently had a precancerous spot removed from my face by my dermatologist. I was surprised that he recommended that I apply Vaseline to the wound under a bandage a couple of times daily to help it heal. Why would that be helpful? Wouldn't an antibiotic ointment be more effective?
A. The American Academy of Dermatology recommends petroleum jelly (petrolatum) on minor wounds to help keep them moist and prevent them from forming a scab. Scabs actually take longer to heal.
One study that compared antibiotic ointment to an ointment without antibiotics found that the petrolatum-based topical treatment was equally effective (Journal of the American Academy of Dermatology, March, 2011). Some people are allergic to topical antibiotics.
* * *
In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of this newspaper or e-mail them via their Web site: www.peoplespharmacy.com. Their newest book is Top Screwups Doctors Make and How to Avoid Them (Crown).