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MEDICAL INFORMATION
ANXIETY
What is
anxiety?
Anxiety is a natural part of human life and useful for helping us deal with
problems and challenges. However there are times when feelings of anxiety
can become so strong or continue for so long that they begin to interfere
with daily life, causing misery and frustration.
What are the symptoms of anxiety?
The symptoms are variable but are often a mixture of physical and emotional
sensations. These may include feeling tired and washed out but perhaps not
sleeping well, worrying constantly, feeling irritable, not being able to
concentrate. People may experience muscle tension and pain, a pounding
heart, indigestion, diarrhoea or constipation, sweating, nausea, loss of
appetite and a dry mouth. They may look pale and tense. Sometimes an
unexpected surge of anxiety results in rapid or heavy breathing,
palpitations, dizziness or faintness and a terrible feeling of panic - a
panic attack. The physical sensations may be so strong that the anxious
person may feel that they have a serious physical illness. Sometimes anxiety
and panic may be associated with feelings of depression and hopelessness.
What causes anxiety?
Sometimes this kind of anxiety can be caused by particularly difficult
circumstances or a traumatic experience. Sometimes it may be a symptom of
underlying depression. However, for many people there may be no obvious
reason why they develop anxiety and it probably arises from a mixture of
different factors.
How can it be treated?
If anxiety has become disabling or long-term, a GP may prescribe an
anti-depressant. These drugs are non-addictive and seem to help feelings of
anxiety as well as depression. They can enable a person to feel in control
of their lives again and able to plan some self-help strategies.
What self-help strategies can be useful?
Talking about the problem is an important aspect of self-help but requires a
trusted listener. If family and friends seem inappropriate, the GP may be
able to refer the sufferer to a counsellor or suggest a psychotherapist.
Psychotherapists vary in their approach to anxiety; they may concentrate on
trying to identify and tackle the cause of the anxiety or they may focus on
trying to change destructive thought patterns and negative attitudes. There
may be a self-help group locally where people who experience similar
problems can meet and support each other.
Changes in daily routine can also be helpful. Regular exercise has been
shown to lift the spirits and increase confidence. It is also worth making
the effort to eat a diet which is balanced and rich in vitamins, rather than
comfort eating. Learning to relax is another important strategy. There are
many different techniques for doing this and there may be a teacher locally
who can help. Audiocassettes for guided relaxation are also available if
joining a class seems too daunting.
Useful sources of information:
MIND (mental health charity), 15-19 Broadway, London E15 4BQ. Telephone: 020
8519 2122. Information Line: 08457 660 163. Website:
http://www.mind.org.uk
The Samaritans. Telephone: 0345 909090
No Panic, 93 Brands Farm Way, Telford TF3 2JQ. Telephone Helpline: 01952
590545. Information Line: 0800 783 1531. Website:
http://www.no-panic.co.uk
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BACKPAIN- ACUTE
What is
acute back pain?
Acute back pain is a condition that lasts for less than four weeks, develops
quickly and can be severe. Most acute back pain affects the lower back, and,
in two out of three cases, clears up spontaneously.
What causes acute back pain?
The causes are varied and may include one or more of the following:
-
Posture -
if your body is out of balance for long periods of time, certain sets of
muscles are overused which may make them painful.
-
Prolapsed
or ruptured disc - one of the vertebrae of the spine ruptures and part of
its soft core protrudes, sometimes touching or trapping a nerve.
-
Pregnancy
- towards the end of pregnancy, weight gain and shift of body balance may
affect posture significantly.
How can
acute back pain be treated?
-
Painkillers.
-
Manipulation from a qualified physiotherapist, osteopath or chiropractor.
-
Gentle
regular activity.
-
If there
has not been a resolution of your pain within 6 weeks, then your GP will
start to arrange tests to explore further. This may include tests such as
MRI (magnetic resonance imaging), CAT (computerised axial tomography) or
referral to a specialist.
How can I
help myself?
-
Improve
my general fitness and flexibility of my back.
-
Control
my weight.
-
Lift
correctly - back straight, knees bent.
-
Move
regularly to ensure even muscle activity.
Useful
sources of information:
BackCare (formerly National Association of Back Pain), 16 Elmtree Road,
Teddington TW11 8ST. Telephone: 020 8977 5474. Website:
http://www.backpain.org
The General Osteopathic Council, Osteopathy House, 176, Tower Bridge Road,
London SE1 3LU. Telephone: 020 7357 6655. Fax: 020 7357 0011. Website:
http://www.osteopathy.org.uk
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BACKPAIN – CHRONIC
What is
chronic back pain?
Chronic back pain lasts for longer than three months. It may come on
gradually over a period of time, or may develop from acute back pain. Most
chronic back pain involves the lower back.
What causes chronic back pain?
The causes are varied and may include one or some of the following:
-
Posture -
if your body is out of balance for long periods of time, certain sets of
muscles are overused which may make them painful.
-
Prolapsed
or ruptured disc - one of the vertebrae of the spine ruptures and part of
its soft core protrudes, sometimes touching or trapping a nerve.
-
Spinal
problems - e.g. scoliosis (twisting of the spine) or spondylolisthesis
(dislocation of the spinal joints).
How is
chronic back pain diagnosed?
In most cases, you will provide the relevant details.
On some occasions your GP may arrange further tests, such as MRI (magnetic
resonance imaging), CAT (computerised axial tomography), or refer you to a
specialist.
How is chronic back pain treated?
-
Manipulation from a qualified physiotherapist, osteopath or chiropractor.
-
Gentle
regular activity and moderate exercise especially to strengthen stomach
muscles.
-
Pain
management - the use of painkillers, muscle relaxants and learning how to
relax may all help the process of dealing with pain and discomfort.
How can I
help myself?
-
Increase
my level of fitness and flexibility of my back.
-
Increase
awareness of my posture.
-
Find ways
to move regularly, even small changes will help.
-
Control
my weight.
-
Lift
correctly with straight back and knees bent.
Useful
sources of information:
BackCare (formerly National Association of Back Pain), 16 Elmtree Road,
Teddington TW11 8ST. Telephone: 020 8977 5474. Website:
http://www.backpain.org
The General Osteopathic Council, Osteopathy House, 176 Tower Bridge Road,
London SE1 3LU. Telephone: 020 7357 6655. Website:
http://www.osteopathy.org.uk
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CERUMEN – EARWAX
Why do we
have earwax?
The canal which leads from the outer ear is a short narrow passage
(approximately 2.5cm long), closed at the far end by a thin flexible
membrane called the eardrum. Earwax (or cerumen, as it is sometimes known),
is produced by the lining of the ear canal near its exterior opening. Its
role is to trap dust and debris, preventing them from reaching the eardrum.
It is a normal body secretion and useful for the healthy functioning of the
ear. Its colour is variable, ranging from yellow to very dark brown, and it
may be almost liquid, sticky or dry in consistency. Not only are there
variations in earwax between different individuals but there may be
variations in the same individual at different times.
When do the ears need cleaning?
In most people the ear canal will not need cleaning, as it is, in a sense,
self-cleaning. Earwax gradually migrates to the outside of the ear where it
is removed by normal washing. It is continually replenished. Putting
anything inside the ear canal, such as cotton buds, tends to push the earwax
deeper into the canal and may pack it against the eardrum. The old adage of
never inserting anything smaller than the tip of one's elbow into the ear
still holds good.
However a few people do produce excessive amounts of earwax, which may lead
to symptoms such as diminished hearing, a feeling of blockage and sometimes
tenderness. In this case it may be necessary to intervene to remove some of
the wax.
What causes excessive earwax?
Working in a dusty environment can stimulate the ears to produce more wax.
If protectors are available, they may help. Trying to clean the ear canal
also stimulates production of wax. In some cases excessive earwax is a
family tendency.
What is the treatment?
Eardrops can be bought at the chemist to soften the wax. The drops should be
inserted as directed and a piece of cotton wool tucked against the entrance
to the ear canal will catch the wax as it drains away.
If this treatment is ineffective, the problem should be referred to a
doctor, who may remove soft wax by syringing or by suction. If the wax is
hard and does not soften after the application of drops, a fine instrument
may be used to hook it out.
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COMMON COLD
What is a
cold?
A cold is a mild viral illness affecting the mucous membranes (soft lining)
of the nose and throat. Most people will catch between two and four colds a
year.
What are the symptoms of a cold?
Common symptoms include: a sore or itchy throat, sneezing, a runny nose,
coughing, feeling unwell, and a raised temperature. Later, the discharge
from the nose becomes thicker and yellow in colour.
How is a cold treated?
There is no effective treatment for a cold. It will clear up on its own
within a few days. However, the following may help relieve the symptoms:
-
Keep
warm.
-
Go to bed
if you feel really unwell.
-
Drink
plenty of fluids.
-
Take
paracetamol if necessary.
-
Take
over-the-counter cold remedies. Many of these also contain painkillers, so
take them instead of, not as well as painkillers.
-
Many
people find home-made hot lemon and honey drinks soothing.
-
Steam or
menthol inhalations may ease a blocked nose.
Are there
any complications?
Colds are common and usually no more than a nuisance, but some people are
troubled by a complication such as sinusitis. Children, in particular, may
get an infection of the middle ear. If you know you always get a
complication following a cold, you may find it helpful to take preventative
measures early on. For example, if you are an asthmatic, you may need to
'double up' your treatment at the first sign of a cold. Using decongestants
may reduce the risk of sinusitis.
Is there any way to stop getting a cold?
Some people believe that taking one gram of vitamin C daily will prevent
colds, but there is little evidence that this works. It has also been
suggested that zinc supplements may help, but studies on this have been
inconclusive.
Washing your hands, and avoiding touching your nose or eyes after coming
into contact with someone with a cold will help stop you getting a cold.
If you have a cold, washing your hands frequently, especially after blowing
your nose, will help prevent it spreading. Use paper tissues, rather than
cloth handkerchiefs, and throw them away after use.
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CONSTIPATION
What is
constipation?
Constipation is the infrequent passage of hard stools.
What causes constipation?
The most common cause of constipation is lack of fibre (roughage) in the
diet. Other common causes are:
-
Insufficient fluid intake.
-
Inactivity.
-
Misuse of
laxatives.
-
Pregnancy.
-
Pre-menstrual syndrome.
-
Some
drugs, for example, drugs containing morphine or codeine, iron tablets,
some antidepressants, and some antacids.
Constipation may also be a feature of some medical conditions, for example:
-
Irritable
bowel syndrome.
-
Underactive thyroid.
-
Diverticular disease.
-
Chronic
renal failure.
-
Depression.
Constipation can sometimes be caused by cancer, but this is unusual.
What can be done to prevent constipation?
Constipation can be prevented by eating a diet high in fibre, and including
fresh fruit and vegetables, unpeeled when possible. Drink plenty of water.
Prune juice may be helpful, as can caffeine-containing hot drinks as
caffeine stimulates the muscles of the bowel.
Try to develop good bowel habits. Don't ignore the urge to go, and try to
set aside a time each day (after breakfast is a particularly good time) to
have a bowel movement.
How can constipation be treated?
Most people have an occasional short period of constipation, for which there
are a number of over-the counter treatments available from your pharmacist.
These include bulking agents, which take about a week to work effectively,
and stimulants such as senna. However, since overuse of laxatives can itself
cause constipation, stimulants are strictly for short-term use only.
If constipation is a problem or you have suddenly become constipated for no
apparent reason, you should contact your doctor. Keep a diary of bowel
movements for a week or two before you see the doctor, and also take details
of any drugs (including laxatives) you have taken.
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CONTRACEPTION
What is
contraception?
Contraception is any effective means of preventing a pregnancy.
What methods are available?
-
Barrier (eg
condom, diaphragm)
This method
works by stopping any sperm from getting into the uterus. Condoms also offer
some protection from sexually transmitted diseases, including HIV.
This method
works by altering a woman's natural hormonal cycle.
-
Intrauterine device/system (IUD/IUS)
This method
involves a small device being fitted into the uterus.
-
Natural
family planning methods (the 'safe period')
These
methods rely on a woman to understand her menstrual cycle, in order to
recognise fertile and infertile times.
This method
involves surgery to permanently block the passage of sperm into the penis or
eggs into the fallopian tubes.
-
Emergency
contraception (eg 'the morning after pill')
This method
is used when other methods have failed or have not been used.
Which method should I choose and how effective will it be?
Some methods are more effective than others, but no type of contraception is
perfect. It is a good idea to discuss all the options with your GP, or
practice nurse, in order to choose the method which is right for you. For
example, sterilisation would only be recommended to someone who already had
children, because it is a permanent method. Natural methods would be
unsuitable if you definitely want to avoid pregnancy, because they rely on a
regular and predictable menstrual cycle and are not as safe as some other
methods.
Where can I get contraception?
-
Your GP
or practice nurse.
-
You
should be able to go to any GP for contraception, including emergency
contraception, but it is best to ring them first.
-
Family
planning clinics.
-
Some
sexual health clinics.
-
Condoms
can be bought in pharmacies and other places, including supermarkets.
-
Emergency
contraception can be obtained from accident and emergency departments, but
telephone first.
What if
contraception fails?
Emergency contraception can be used if usual methods have failed. If you
have not used contraception and pregnancy is suspected, contact a doctor as
soon as possible.
Useful sources of information:
The Family Planning Association (fpa), 2-12 Pentonville Road, London, N1
9FP, Helpline: 020 7837 4044. Website:
http://www.fpa.org.uk
Brook Advisory Centres, 165 Gray's Inn Road, London, WC1X 8UD. Telephone:
0207 617 8000
Marie Stopes International, 153 Cleveland Street, London, W1P 5PG.
Telephone: 0207 574 7400. Website:
http://www.mariestopes.org.uk
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COPING WITH BEREAVEMENT
Losing
someone you love is one of life's most stressful events, and is an
experience that most people have to cope with at some time. Many people are
quite unprepared for the wide range of emotions, and even physical symptoms,
that they experience following a death, even when the death was expected.
Common emotions include guilt, denial, disbelief, shock, and anger, and are
all a normal part of the grieving process.
Some ways to cope with grief
-
Do not
bottle up your feelings. Talk to your friends and relatives about how you
feel. If the person died in hospital or a hospice, for example, find out
if the staff run a support group. Other people you can talk to include
your general practitioner, a minister of religion, or a member of one of
the support groups listed below.
-
Take care
of your physical health, and make sure you eat properly.
-
Put off
any major life changes.
-
Be
patient. You will never stop missing your loved one and it may take months
or even years before you accept that your life has changed.
Some ways
that you can help other people to cope with grief
-
Encourage
them to talk about their feelings.
-
Avoid
platitudes such as saying 'It was for the best'.
-
Offer
practical help (for example, cooking or shopping), but don't get upset if
it is refused.
-
Suggest
professional help if you feel it is necessary.
Useful
contacts:
For all bereaved people:
Cruse Bereavement Care, 126 Sheen Road, Richmond, Surrey TW9 1UR. Telephone:
0870 167 1677. In Scotland, telephone: 0131 551 1511. In Wales, telephone:
0345 585565. In Northern Ireland, telephone: 0123 792 419. Website:
http://www.crusebereavementcare.org.uk
For bereaved parents:
The Compassionate Friends, 53 North Street, Bristol BS3 1EN. Telephone
Helpline: 0117 953 9639 (daily, 9.30am to 10.30pm). Website:
http://www.tcf.org.uk
For advice and help on practical matters following a death:
Help The Aged, 207-221 Pentonville Road, London N1 9UZ. Telephone: 020 7278
1114. In Scotland, telephone: 0131 311 8500. Website:
http://www.helptheaged.org.uk
For bereaved pet owners:
The National Coordinator, Pet Bereavement Support Service, The Blue Cross,
Shilton Road, Burford, Oxon OX18 4PF. Telephone: 01993 822651. Helpline:
0800 096 6606. Website:
http://www.bluecross.org.uk
For anyone finding it hard to cope:
The Samaritans National Helpline: 0345 909090
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CUTTING DOWN ON CHOLESTEROL
What is
cholesterol?
Cholesterol is a waxy, fatty substance, naturally produced by the liver. It
is necessary for the body, forming part of all cell membranes. It also has a
role in the formation of steroid hormones, and helps synthesise Vitamin D
and bile acids, which are essential for the digestion of dietary fats.
Cholesterol is present in many foods, including eggs and shellfish.
Is cholesterol a problem?
Cholesterol is not a problem unless there is too much of it in the body.
When this happens, it can contribute to the formation of fatty deposits -
known as plaques - in the arteries, causing them to narrow. Eventually, the
flow of blood in that artery may be blocked. If this happens to a blood
vessel in the heart, it may cause a heart attack. If it happens in the
brain, it may cause a stroke. Other factors, such as smoking, also
contribute to plaque formation.
However, the situation is slightly more complicated because cholesterol is
transported around the body as part of a substance known as a 'lipoprotein'.
The two most important ones are:
-
Low
density lipoproteins (LDL) - these are rich in cholesterol and transport
cholesterol from the liver to the body tissues. Too many LDLs circulating
in the blood are associated with an increased risk of heart disease.
-
High-density lipoproteins (HDL) - the role of these is to transport excess
cholesterol from the tissues and walls of the arteries back to the liver,
where they are broken down. In other words, these are the good cholesterol
transporters.
The risk of
developing heart or blood vessel disease also depends on the ratio of these
two lipoproteins.
Other types of fat naturally found in the body are known as triglycerides.
Raised levels of these are also associated with an increased risk of heart
disease.
What causes raised cholesterol levels?
Causes include eating a diet high in saturated fat, stress, and a genetic
predisposition.
How can I reduce my cholesterol levels?
If your cholesterol levels are high, you should comply with medical advice
as to how to reduce them. Diet can help, particularly adopting a
'Mediterranean style' diet. This involves eating more fresh fruit and
vegetables, whole-grain cereals, nuts and seeds, and substituting fish,
poultry and pulses for red meat.
Oily fish
contains essential fatty acids known as the Omega-3 family. These help
reduce blood triglyceride levels and play a part in reducing the formation
of blood clots, and in lowering blood pressure. Choose fish such as salmon,
pilchards, sardines, mackerel, kippers and trout. It can be fresh or tinned,
but avoid smoked varieties if possible. Tuna is actually an oily fish while
fresh, but loses the Omega-3 properties once canned.
Current recommendations suggest that you should eat 2-3 large portions
(around 100 grams per portion) per week.
This does not mean to suggest that white fish should be avoided - being low
in fat, it forms a valuable part of a healthy diet. However, oily fish is
better for the heart.
-
Choose
the right type of fat.
Cut down on
saturated fat (found in animal products), and opt for unsaturated fats, in
particular, monounsaturated fats, such as in olive or rapeseed oil, nuts and
seeds.
-
Eat more
fruit, vegetables, nuts and pulses (beans, peas, lentils).
Current
guidelines are to eat at least 5 portions each day. The following are
examples of a portion:
-
1
apple/banana/pear/orange
-
2 small
fruits - e.g. plums/kiwi fruits
-
12-15
grapes/berries
-
2
tablespoons vegetables/pulses
-
1 oz
nuts/seeds
Choosing
fresh ingredients automatically serves to protect our bodies, as it also
limits the intake of sodium, hidden fats, and additives.
What about alcohol?
A little of what you fancy does do you good, and a moderate amount of
alcohol is thought to be beneficial to heart health. In the traditional
Mediterranean diet, wine is consumed in moderate amounts, particularly at
mealtimes.
It is wise to keep alcohol to moderate amounts and current recommendations
suggest that men should drink no more than 21 units per week, and women
should take no more than 14 units per week, spread out over a whole week. A
unit of alcohol is equivalent to:
-
1 x 125
ml glass of wine (9%)
-
½ pint
ordinary strength (3.5%) beer/lager/cider
-
¼ pint
strong (8-9%) beer/lager/cider
-
1 x
single pub measure of spirits
-
1 x
single measure of sherry
Can I do
anything else?
Other factors known to contribute to heart disease include smoking,
hypertension, stress, being overweight, high blood pressure, and inactivity.
So as well as following the dietary recommendations and maintaining a
healthy weight, think about giving up smoking, taking regular exercise, and
learning an effective relaxation technique.
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CYSTITIS
What is
cystitis?
Cystitis is an infection of the bladder, usually caused by bacteria entering
via the urethra (the tube leading to the outside from the bladder).
What are the symptoms of cystitis?
The symptoms are:
-
Pain or
burning sensation when passing urine.
-
Needing
to pass urine frequently.
-
Cloudy or
foul smelling urine, possibly with a small amount of blood
-
Pain just
above the pubic bone.
Who gets
cystitis?
Anyone can get cystitis. However, it is more common among women because they
have a shorter urethra than men. Women are also more at risk because of the
following:
-
During
sexual intercourse, bacteria may be pushed up into the bladder.
-
Use of
contraceptive diaphragms may irritate the urethra.
-
Hormonal
changes during pregnancy, immediately after giving birth, and during the
menopause.
Other risk
factors are:
-
Diabetics
because sugar in urine encourages bacterial growth.
-
Urinary
tract obstruction, such as in men with an enlarged prostate gland which
prevents the bladder from emptying properly.
-
Congenital abnormalities of the urinary tract.
How is
cystitis treated?
Cystitis can be treated with antibiotics. Before starting treatment, a
mid-stream sample of urine will be collected and sent to the laboratory for
culture. Always complete the full course of treatment, even if things
improve fairly quickly. If however, the infection does not seem to be
improving within two or three days, go back to your doctor, as you may need
a change of antibiotics.
Prevention is better than cure, so if you are prone to cystitis, the
following may help to prevent attacks:
-
Wear
cotton underwear and socks or stockings instead of tights.
-
Avoid
wearing tight underwear or jeans.
-
Use a
water-soluble lubricant during intercourse and empty your bladder as soon
as possible after intercourse.
-
Take a
shower rather than a bath. If you have a bath, don't use perfumed bubble
bath.
-
Try
changing your washing powder or fabric conditioner.
-
Cut down
on coffee, tea and alcohol.
-
Drink
plenty of water.
-
Sit
properly on the toilet. "Hovering" over the toilet seat can prevent your
bladder from emptying properly.
If you do
have an attack, consult your doctor. In the meantime, the following may help
with the symptoms:
-
Take
paracetamol for the pain. A warm hot water bottle on your lower abdomen
may also help.
-
Aim to
drink a pint of water an hour during the initial stages of an attack.
-
Consult
your pharmacist for an over the counter treatment. These work by making
the urine alkaline which helps to prevent the bacteria multiplying.
-
Drinking
lemon barley water or cranberry juice may help to relieve the symptoms.
-
You may
find that sitting in a bath of warm water or pouring it over the area
while you sit on the toilet soothes any discomfort.
Mild cases
often resolve on their own if you follow the above advice. If, however, you
have severe or recurrent attacks, you may need to be referred to a urology
specialist for further investigations.
Useful source of information:
Cystitis and Candida Support Group, 6-9 Bridgewater Square, London EC2 8AH.
Telephone: 020 7256 2993
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DEPRESSION
What is
depression?
Depression is a common illness in which there is a prolonged low mood. This
affects the ability to carry out everyday tasks.
How do I know if I'm depressed?
You may experience some or all of the following:
-
Lack of
interest in and pleasure from usual activities and interests, including
sex.
-
Poor
attention and concentration.
-
Change in
appetite, leading to noticeable weight gain or loss.
-
Constant
feelings of tiredness, yet still feeling weary after sleep.
-
Finding
it hard to make even simple decisions.
-
Feelings
of worthlessness and hopelessness.
-
Thoughts
of self-harm and suicide.
-
Early
morning wakening (commonly 4 - 5 a.m.)
What causes
depression?
Depression may be a response to significant life changing events, such as
the death of someone close, loss of work or severe illness. There are times,
however, when it can seem to come from 'out of the blue'. However, it is now
known that an imbalance of certain chemicals in the brain also causes
depression.
How is depression treated?
Ask for help from your doctor who may suggest a 'talking treatment' with a
professional and/or prescribe antidepressants: these are not addictive and
usually work by altering the balance of chemicals in the body. They often
take a couple of weeks to take full effect.
Complementary medicine from a qualified practitioner may be of benefit in
addition to the above.
Will I need to see a psychiatrist?
The vast majority of people are treated successfully by their GP If the
symptoms are severe and prolonged, then expert psychiatric help may be
needed.
How can I help myself?
-
Accept
that you are experiencing depression which is a common experience.
-
Do talk
about what's happening in your life and how you feel about it to others
who can provide you with a 'listening ear'.
-
Focus on
how good you will feel after physical activity and then do it: going for a
walk is fine.
-
Set
realistic and achievable goals
Useful
sources of other information
The
Samaritans: Helpline: 0345 909090
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DIET
What is a
good diet?
A good diet is:
-
Enjoyable.
-
Made up
of a range of foods.
-
Made up
of the right amount of food to be a healthy weight.
What do I
need to do to ensure that I'm following a good diet?
Buying and eating the five types of food in the correct proportion will
usually ensure that our bodies have what they need to ensure growth, energy
and repair.
The five types are:
-
Carbohydrates (complex rather than simple - e.g. bread, potatoes, pasta
and rice).
-
Protein -
e.g. meat, fish, cheese, eggs, nuts, pulses.
-
Fat -
e.g. olive oil, butter.
-
Vitamins
- found in a range of fresh foods.
-
Minerals
- also found in a range of fresh foods.
One way to
understand the correct daily proportions is as the shape of a pyramid with
the following layers starting at the bottom:
-
Between
6-11 servings of complex carbohydrate.
-
At least
5 pieces of fruit and vegetables.
-
Up to 2-3
servings of meat, fish, pulses, eggs, nuts, milk. yoghurt and cheese.
-
Sparing
amounts of fats and sugar.
What can I
do for myself to ensure that I'm following a good diet?
-
Increase
your understanding about which foods provide the elements that your body
needs for growth, energy and repair.
-
Buy and
eat a wide range of foods, especially carbohydrates, fruit and vegetables.
-
Use a
variety of ways to cook food, i.e. grill, steam and poach as well as
boiling, roasting and frying.
-
Buy fewer
pre-made foods, which are often high in salt and fat.
Useful
sources of information:
British Nutrition Foundation, High Holborn House, 52-54 High Holborn, London
WC1V 6RQ
Telephone: 020 7404 6504. Fax: 020 7404 6747
Website:
http://www.nutrition.org.uk
Weight Watchers. Telephone: 0345 123 000 (phone to find out about local
groups).
Website:
http://www.weightwatchers.co.uk
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DRUG MISUSE
What is
drug misuse?
Drug misuse is when someone uses an illegal drug, such as ecstasy, or a
legal drug, such as tranquillisers, for no medical purpose. People can also
misuse solvents, the gases found in some aerosol cans, and alcohol (if they
drink to excess just to get drunk).
Why do people misuse drugs?
Many people who start to misuse drugs do so because they aren't aware of, or
don't believe the dangers. One of the problems is that people may have seen
someone else taking a drug, and if nothing bad has happened to that person,
they don't think it will happen to them either. Other reasons for drug
misuse include peer pressure, experimenting as a part of growing up,
rebelling against authority, enjoying the short-term effects (the 'high'),
or just that drugs are cheap or easily available.
What are the dangers of drug misuse?
The dangers depend on the type of drug, the amount taken, the person who
takes it, and the circumstances in which the drug is taken. Problems
include:
-
With
illegal drugs, it is impossible to tell what the substance is, or what it
has been mixed with. Therefore, the user doesn't know what effect the drug
will have on them, even if they have tried it before.
-
Accidental overdose is a real danger with illegal drugs, as it is also
impossible to tell how strong the drug is, or to control the dose being
taken. Taking a drug just once can kill, even if someone else has taken it
with no problems before.
-
Drug
dependency or addiction - some drugs like heroin and crack cocaine are
extremely addictive, but taking any kind of drug regularly can become a
habit, and have adverse effects on health, even if the user is not
physically dependent.
-
Contracting infections such as HIV or hepatitis from sharing needles
-
Serious
adverse effects from mixing drugs, including taking drugs and drinking
alcohol at the same time.
-
Possession of drugs is a criminal offence, and getting caught can result
in a criminal record, and possibly a prison sentence. Having a criminal
record for drug offences can affect the user's employment chances, and can
make it hard to obtain a visa to travel to some countries.
-
Long-term
physical and mental health problems.
-
Getting
into risky situations when under the influence of drugs, such as getting
run over, having a car crash, having unprotected sex.
-
Turning
to crime to finance a drug habit.
How can I
tell if someone I know is misusing drugs and what should I do?
Possible signs that someone is misusing are mood swings, excessive
tiredness, loss of appetite, changes in school or work attendance, weight
loss, poor skin, and being secretive. However, these signs don't definitely
mean that someone is taking drugs. If you haven't seen someone in a state of
intoxication, you can't be sure. The best thing to do if you are worried is
to talk to them about it, but choose a sensible time and place, remain calm,
and try not to let the situation turn into a confrontation. Think beforehand
about what you will say and do if your child/friend admits they are taking
drugs. There are many organisations to support families - see below for
contact details.
What agencies provide help for drug misusers?
-
The
National Drugs Helpline is the major source of information and support to
drug users, giving free, confidential, 24-hour advice and information.
They can also provide details of local agencies and specialist services.
Contact them on 0800 77 66 00. Website:
http://www.ndh.org.uk
-
Local
drugs agencies provide advice, sterile needles and syringes, counselling,
supervised detoxification and other therapies such as yoga and
acupuncture. Contact the National Drugs Helpline for details of your local
agency.
-
For
people who are dependent on hard drugs, drug dependency units (DDUs)
provide counselling, detoxification, substitute prescribing and other
related therapies, and are usually located near hospitals. Waiting lists
for treatment can be long.
-
Community
drug teams (CDTs) offer similar services to DDUs, except as their name
suggests, they are often located in the community.
-
Outreach
services attempt to bring the service to the user, offering individual
advice, and support such as clean injecting equipment and condoms.
-
Needle
exchange schemes give out clean injecting equipment and collect used
equipment. These services often offer information and advice, health check
ups, safer sex advice and condoms. Some schemes are based within drug
projects but others operate from hospitals or chemist shops.
-
Your GP
may be able to offer advice, and can refer you to other specialist
services
-
If you
have been arrested for a drugs offence, Release runs a 24 helpline.
Telephone: 020 7603 8654.
-
Narcotics
Anonymous is a network of self-help groups for drug users based on the
Alcoholics Anonymous approach. Telephone: 020 7251 4007. Website:
http://www.ukna.org
Information
for the families of those misusing drugs:
-
The
National Drugs Helpline (see above) is an excellent source of information.
-
ADFAM is a national
charity working with families affected by drugs and alcohol and is a
leading agency in substance related family work. It provides a range
of publications and resources for families about substances and criminal
justice and operates an online message board and searchable database of
local support groups that helps families hear about and talk to people who
understand their situation. Adfam runs a range of training
programmes on substances and family support. It also operates direct
support services at London prisons for families of prisoners with drug
problems. A list of resources is available online. Waterbridge House, 32-36 Loman Street, London SE1 0EH. Telephone:
020 7928 8898. Website:
http://www.adfam.org.uk
-
Families
Anonymous (self-help groups for families of people with drug problems).
Telephone: 020 7498 4680. Website:
http://www.famanon.org.uk
Other
useful contacts:
DrugScope, Waterbridge House, 32-36 Loman Street, London SE1 0EE. Telephone:
020 7928 1211. Website:
http://www.drugscope.org.uk
Drinkline (free and confidential advice about alcohol). Telephone: 0800 917
8282
Alcohol Concern: Telephone: 020 7928 7377. Website:
http://www.alcoholconcern.org.uk
Department of Health drug misuse information:
http://www.doh.gov.uk/drugs
Health Promotion England:
http://www.hpe.org.uk
Trashed (a website for 14-19 years olds):
http://www.trashed.co.uk
D-2K (a website for 14-16 year olds):
http://www.d-2k.co.uk
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HEAD LICE
What are
head lice?
Head lice are small wingless insects that live on the human scalp. They feed
by sucking blood, leaving tiny red bite marks that usually itch. They are
very contagious. The eggs that they lay on hairs are called 'nits'.
What are the symptoms of head lice?
Many people experience itching because of the bites. You may also notice:
-
Small
black dots (lice droppings) on your clothing.
-
Groups of
tiny, pale eggs (nits) clustered around the base of individual hairs.
-
Small
white dots (empty cases left after the 'nits' have hatched) in the hair.
How are
head lice treated?
The best way to search for head lice and 'nits' is to use a special comb
available from a pharmacy and then:
-
Wet the
hair with water
-
Lean over
a sheet of light coloured paper or cloth
-
Comb the
hair in small sections from the roots to the very end of the hair.
If you find
lice or 'nits' on the paper or cloth then one of the following treatments is
possible:
-
Insecticides, available in lotion form from a pharmacist, which need to be
applied according to instructions.
-
Wet
combing or 'bug busting', which involves wetting the hair, applying
conditioner, then combing it with a 'nit' comb for at least 30 minutes
every third or fourth day over a two week period. The aim is to remove any
live lice and eggs until none are left.
-
Ask your
pharmacist: some herbal shampoos and essential oils, such as tea tree oil,
may be helpful.
If one
person in a family has lice, it's advisable to treat all members of the
family.
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HERPES SIMPLEX
What is
herpes simplex?
Herpes Simplex is the name of the virus that causes both cold sores (also
called oral herpes or herpes labialis) and genital herpes.
What are cold sores?
Cold sores are small blisters that usually occur around the mouth, although
they can appear anywhere on the body. They are caused by a strain of the
herpes virus known as HSV-1.
Who gets cold sores?
Anyone can get cold sores. Around 80% of the population are infected with
the virus at some time in their lives, and 20% of these will suffer
recurrent attacks.
What are the symptoms of cold sores?
At first, there is an unpleasant tingling or itching sensation in the skin.
A day or two later, small blisters appear at the site of the tingling. These
become covered by scabs which eventually fall off.
How are cold sores treated?
The best treatment is to take action at the first sign of symptoms. Ask your
pharmacist for an over-the-counter antiviral cream before you have an attack
and apply it as soon as the tingling starts. Once the blisters appear, there
is little you can do except keep the area clean.
Can cold sores be prevented?
If you are susceptible to cold sores, there is probably little you can do to
stop getting them. However, you can prevent other people from becoming
infected by using your own towel and face cloth, by not kissing anyone or
letting them touch the sores, and by avoiding oral sex while you have a
sore.
What is genital herpes?
Genital herpes are 'cold sores' in the genital area. They are usually caused
by a strain of the herpes virus known as HSV-2, but, in some cases, they can
be caused by HSV-1.
What are the symptoms of genital herpes?
The first symptom is an unpleasant prickly or burning sensation in the
genital and/or rectal area. Up to two days later, small blisters appear on
the skin. These turn into small ulcers over the next two or three weeks.
There can also be discomfort on passing urine. The first attack is usually
the worst.
How is genital herpes treated?
Do not try to treat yourself. You can see your general practitioner or
attend a genito-urinary medicine (GUM) clinic for specialist treatment. You
can refer yourself to the clinic and treatment is confidential. Drugs used
include antiviral creams and tablets.
Can genital herpes be prevented?
The following measures may help:
-
Always
use a condom during sex, including oral sex.
-
Do not
have sex if you or your partner have any blisters or ulcers in the genital
region.
-
Avoid
oral sex if you have a cold sore on your mouth.
Is there
anything I can do to help myself?
-
Find out
what triggers your attacks, and try to avoid it.
-
Don't
touch the blisters and ulcers.
-
Seek
medical help quickly if you think you have genital herpes, and if you have
a repeat attack.
Pregnant
women who are susceptible to genital herpes should inform their doctor, as
delivery may need to be by caesarean section in order to minimise the small
risk of the baby becoming infected.
Useful source of information:
The Herpes Virus Association, 41 North Road, London N7 9DP. Telephone: 020
7607 9661. Website:
http://www.herpes.org.uk
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HIATES HERNIA
What is a
hiatus hernia?
The stomach and intestines are separated from the heart and lungs by a
strong sheet of muscle called the diaphragm. Passing through this sheet of
muscle is the oesophagus (gullet) - the tube linking the mouth to the
stomach. Normally the opening in the diaphragm through which it passes is
close-fitting, but in some people the opening becomes enlarged and weakened,
allowing part of the upper stomach to slip up into the chest. This is known
as a hiatus hernia.
What is the cause of hiatus hernia?
The cause is not known, although it is relatively common. Symptoms often
occur in middle age, although the condition can be present at birth.
What are the symptoms of hiatus hernia?
Many people with a hiatus hernia experience no symptoms and may not know of
its existence. The commonest symptom is indigestion or heartburn - a burning
pain felt behind the breastbone, sometimes reaching through to the back.
This may be exacerbated by bending or lying down, and may follow a meal,
particularly a large or fatty meal. The pain of heartburn is caused by acid
from the stomach being regurgitated into the oesophagus, because of the
hiatus in the diaphragm. This is known as reflux.
How is a hiatus hernia diagnosed?
If heartburn is frequent and painful, it is important to visit the doctor to
ensure that the symptoms do relate to the oesophagus. The diagnosis of
hiatus hernia can be confirmed by a barium x-ray or by endoscopy, where a
viewing tube is used to look at the oesophagus and stomach.
How is hiatus hernia to be treated?
Antacids, which neutralise the effects of gastric acid, can be bought over
the counter, reducing the pain. There are also medicines available on
prescription, which can decrease the amount of acid produced by the stomach
or strengthen the muscles at the lower end of the oesophagus, thereby
reducing the amount of reflux. Where medical treatment fails and
complications develop - such as narrowing of the end of the oesophagus due
to scarring from the gastric acid - an operation may be performed.
What self-help measures can be taken?
-
Stop
taking anti-inflammatory drugs, such as aspirin or ibuprofen, which worsen
the symptoms. However, if you are taking prescribed anti-inflammatories,
you should discuss this with your doctor.
-
Try to
avoid large meals, particularly last thing in the evening. They increase
the pressure inside the stomach, causing more reflux.
-
Try to
avoid fatty meals. These are digested slowly, prolonging the discomfort.
-
If any
foods seem to cause heartburn, avoid them. These may include alcohol and
coffee.
-
If you
are a smoker, seek help to stop smoking. Nicotine relaxes the muscle at
the lower end of the oesophagus, increasing reflux.
-
If you
are overweight, seek help and advice about achieving an appropriate weight
for your height and build. Fatty tissue around the stomach and intestines
raises the intra-abdominal pressure, causing more reflux.
-
If you
suffer frequently from constipation, seek advice about how to avoid it, as
any form of straining will increase reflux.
-
If
heartburn is a particular problem at night, raise the head of the bed,
either with pillows or by raising the mattress at the head end.
Useful
source of information:
Digestive Disorders Foundation, 3, St Andrew's Place, Regents Park, London
NW1 4LB.
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HYPERTENSION
What is
blood pressure?
Blood pressure is the force with which the heart pumps blood around the
body. During the heart's action, there is a period when the pressure is high
(called the systolic pressure) and a period when the heart is relaxed and
the pressure is low (called the diastolic pressure). Blood pressure varies
naturally over a 24-hour period and, just as there is no such thing as
"normal" height, there is no such thing as "normal" blood pressure.
So what is high blood pressure (hypertension)?
As a rough guide, a systolic pressure of under 140 mm Hg and a diastolic
blood pressure of under 90 mm Hg, written as 140/90 mm Hg, are considered
normal. Figures above 160/100 mm Hg are considered high. However, most
doctors will not make a diagnosis of hypertension until you have had a
number of readings taken over a period of time, normally three months.
What causes hypertension?
Hypertension is caused when there is increased resistance to the flow of
blood through the blood vessels. In some cases this may be as a result of
kidney or other disease, but in many cases there is no underlying cause.
However, it is known that smoking, being overweight, eating too much salt,
and lack of exercise are all contributory factors to high blood pressure.
Is hypertension dangerous?
Hypertension is dangerous because it is a risk factor for both heart attack
and stroke. The higher the blood pressure, the more at risk you are. In some
people who have additional risk factors for these diseases, for example,
diabetics, hypertension becomes dangerous at lower levels, so diabetics are
treated if their blood pressure exceeds 140/80 mm Hg.
What are the symptoms of hypertension?
Usually hypertension has no symptoms.
How can hypertension be treated?
The best treatment is lifestyle changes. Stopping smoking, maintaining a
healthy weight, reducing your fat and salt intake, and taking regular
exercise are all helpful in keeping your blood pressure at a healthy level.
Some people find that learning relaxation techniques also helps. Many
people, however, need drugs to treat their hypertension. These drugs need to
be taken for life.
Useful source of information:
The Hypertension Trust, 127 High Street, Teddington, Middlesex, TW11 8HH.
Telephone: 020 8977 0011. Website:
http://www.hypertensiontrust.org
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INCONTINENCE
What is
incontinence?
Incontinence is the inability to control your bladder or bowel, so that you
wet or soil yourself. It is estimated that over three million adults in this
country suffer from incontinence. Many of these suffer from nocturnal
enuresis – bed wetting when asleep.
What causes incontinence?
Incontinence has a number of causes. In women, the pelvic floor may be
weakened by childbirth. In men, the cause may be an enlarged prostate gland.
Other causes include infection, bladder stones and spinal cord damage.
How can incontinence be treated?
Because incontinence is a symptom of several conditions, there is no one
single treatment. It may be treatable with drugs or surgery. Your GP may be
able to treat you, or it may be necessary for you to be referred to a
hospital specialist for investigations and treatment. Many areas have
specialist nurse continence advisers who may also be able to help.
Is there anything I can do to help myself?
There are a number of ways you can help yourself:
-
Drink at
least six glasses of water a day as incontinence can be caused by
over-concentrated urine irritating your bladder wall.
-
Cut down
on drinks containing caffeine (tea, coffee, cola, chocolate), especially
in the evening. Caffeine is a diuretic – that is, it makes you need to
pass urine more often.
-
Avoid
becoming constipated.
-
Some
drugs may cause incontinence. If you think this may be the case, discuss
it with your doctor, as there may be alternative drugs available or it may
be possible to alter the dose. Do not stop taking any drugs without
consulting your doctor.
-
If your
problem is nocturnal enuresis, you may find that an enuresis alarm is
helpful. Contact your GP or the nurse continence advisor.
-
If you
are prone to cystitis, avoid anything that triggers an attack and treat
attacks promptly.
-
Do pelvic
floor exercises. Tighten your back passage as if you are trying to stop
passing wind; now tighten the muscles around the base of your bladder as
if you are trying to stop yourself passing urine. In both cases, count to
four and let go. Repeat at least four times a day. Our leaflet “Pelvic
floor exercises” gives more details or ask the nurse continence advisor to
teach you how to do them.
Useful
sources of information:
Continence Foundation, 307 Hatton Square, 16 Baldwin Gardens, London EC1N
7RL. Telephone: 020 7831 9831. Website:
http://www.continence-foundation.org.uk
Incontact, United House, North Road, London N7 9DP. Telephone: 020 7700
7035. Website:
http://www.incontact.demon.co.uk
For childhood bed wetting, contact ERIC (Enuresis Resource and Information
Centre), 34 Old School House, Britannia Road, Kingswood, Bristol BS15 2DB.
Telephone: 0117 960 3060. Website:
http://www.enuresis.org.uk
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INSOMNIA
|
What
is insomnia?
Insomnia is when you have trouble sleeping. This may mean difficulty
getting to sleep, waking frequently, or waking early and not being
able to return to sleep.
What causes insomnia?
The causes are varied. Some of the following may apply to you:
-
Stress, worry or anxiety.
-
Shift working, which disturbs patterns of sleep.
-
Sleep apnoea, (severe snoring and waking with a start).
-
Restless legs syndrome (Ekbom syndrome), which features itchy,
twitchy or burning sensations in the leg muscles.
-
Depression.
-
A
personal over estimation of how much sleep we need - as we get
older, so we need less sleep.
How
is insomnia treated?
The key is to identify specifically how your sleep is affected and the
cause.
Once identified, your treatment can then take one of the following
forms:
-
Food: avoid eating too close to bedtime, or going to bed hungry.
-
Caffeine, alcohol and cigarettes all disrupt sleep, so avoid close
to bedtime.
-
Increase your physical activity.
-
Develop a bedtime routine.
-
Learn relaxation techniques, e.g. yoga and meditation.
-
Talk with your GP about snoring.
-
Write a diary or journal to form part of your bedtime routine.
-
Consult a qualified complementary health practitioner, e.g.
homeopath, reflexologist, masseur or acupuncturist.
|
Useful
Sources of Information
British Snoring and Apnoea Association, 1 Duncroft Close, Reigate, Surrey,
RH2 9DE. Tel: 01249 701010
Fax: 01737 248744. E-mail:
helpline@britishsnoring.co.uk
Website:
http://www.britishsnoring.co.uk
Narcolepsy Association UK, Craven House, 1st Floor, 121, Kingsway, London,
WC2B 6PA.
Tel: 020 7721 8904. Fax: 01322 863056. E-mail:
info@narcolepsy.org.uk
Website:
http://www.narcolepsy.org.uk
Sleep Matters, Medical Advisory Service, PO Box 3087, London, W4 4ZR
Helpline: 020 8994 9874 (6 pm - 9 pm weekdays)
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IRRITABLE BOWEL SYNDROME
What is
irritable bowel syndrome?
Irritable bowel syndrome (IBS) is a common disorder characterised by a
number of symptoms, including intermittent diarrhoea and/or constipation,
abdominal bloating, abdominal pain and a feeling of incomplete emptying of
the rectum.
What causes irritable bowel syndrome?
The cause is unknown. However, there does seem to be a loss of co-ordination
of the normal peristaltic action of the bowel. This may be because the bowel
is over-sensitive to certain stimuli, for example, certain foods. Stress and
lack of physical activity have also been implicated.
It is estimated that about 1 in 3 people suffer occasionally from IBS; in 1
in 10 sufferers the symptoms are severe enough for them to go to the doctor.
How is irritable bowel syndrome diagnosed?
No single test will diagnose IBS. The diagnosis is usually made on clinical
symptoms. Referral to a gastro-enterologist may be necessary for a few
people to exclude other conditions.
It is important to note that, although it can be unpleasant, IBS is not
life-threatening and will not lead to bowel cancer.
How is irritable bowel syndrome treated?
The following may help:
Avoid stress or learn techniques, such as yoga or meditation, to help you
deal with it.
Drink plenty of water.
Try keeping a food diary to find out which foods make your symptoms worse.
Coffee, tea, alcohol, red meat, dairy products and spicy foods are common
triggers.
Eat a high fibre diet, including fresh fruit and vegetables.
Take regular exercise.
Certain drugs may help. Ask your pharmacist for advice, as most of them can
be bought without a prescription. Otherwise, consult your GP.
Some alternative therapies may help.
Useful sources of information:
Digestive Disorders Foundation. Telephone: 020 7486 0341. Fax: 020 7224
2012. Website:
http://www.digestivedisorders.org.uk
Or write to: Digestive Disorders Foundation, PO Box 251, Edgware, Middlesex,
HA8 6HG (Please enclose an SAE).
IBS Network, Northern General Hospital, Herries Road, Sheffield, S5 7AU.
Telephone: 0114 261 1531 (Please enclose an SAE and £1 coin if writing).
Website:
http://www.ibsnetwork.org.uk
The United Kingdom Register of IBS Therapists, PO Box 57, Warrington, WA5
1FG. Telephone: 01925 629 437
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MENOPAUSE
What is the
menopause?
The menopause, also referred to as the change of life or the climacteric, is
the permanent cessation of periods. It usually happens between the ages of
45 and 55.
Why does the menopause occur?
The menopause occurs because the ovaries stop producing the hormone
oestrogen. This happens gradually, so periods usually become irregular
initially before stopping altogether.
What are the symptoms of the menopause?
Many women have few, if any symptoms. However, hot flushes and night sweats
are fairly common. Other symptoms include:
-
Vaginal
dryness.
-
Tiredness
and difficulty sleeping.
-
Urinary
problems.
-
Irritability, mood swings and poor concentration.
-
Reduced
sex drive.
The fall in
oestrogen levels also means that, after the menopause, women can develop
osteoporosis (thinning of the bones) and become more prone to heart disease
and stroke.
What can be done to alleviate the symptoms of the menopause?
Hormone replacement therapy (HRT) can be very effective in alleviating
menopausal symptoms. HRT can be taken by mouth, implanted under the skin, or
in the form of a gel or patch, and preparations are available containing
different proportions of hormones. HRT is only available on prescription,
and is not suitable for everyone.
Is there anything I can do to help myself?
Keep active. Regular weight-bearing exercise - such as walking - helps
prevent osteoporosis and improves general well-being. Increase your calcium
intake by eating low-fat dairy products. It has also been suggested - but is
unproven - that soya products are beneficial because they contain substances
known as phyto-oestrogens that are similar in action to oestrogen produced
by the body.
Useful sources of information:
Women's Health, 52 Featherstone St, London EC1 8RT (enclose sae if writing).
Telephone: 020 7251 6580 (09.30 am to 1.30 pm, Monday to Friday). Website:
http://www.womenshealthlondon.org.uk
Women's Health Concern, PO Box 2126, Marlow, Bucks SL7 2RY. Telephone: 01628
488065. Helpline: 01628 483612. Website:
http://www.womens-health-concern.org
The Amarant Trust. Helpline: 01293 413000 (11 am to 6 pm, Monday to Friday)
The British Menopause Society, 36 West Street, Marlow SL7 2NB. Telephone:
01628 890199. Website:
http://www.the-bms.org
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MENORRHAGIA
What is
menorrhagia?
The word menorrhagia means heavy periods.
How do I know if my periods are heavy?
Blood loss during menstruation is very subjective, and what one person
considers normal another may consider excessive. The average amount of blood
lost during menstruation is about 60 mls. As a rough guide, your periods are
heavy if you regularly soak through the most absorbent sanitary towel or
tampon in less than two hours, or need to use a tampon and a towel together,
or if bleeding lasts longer than seven days. You may also pass large clots.
Many women experience an occasional heavy period, but, if your periods are
disrupting your life every month, you are almost certainly suffering from
menorrhagia.
What causes menorrhagia?
The following may cause menorrhagia:
-
Fibroids.
-
Polyps.
-
Endometriosis.
-
Use of
the intra-uterine contraceptive device.
-
Pelvic
inflammatory disease.
-
Hormonal
imbalances, particularly in early adolescence and as the menopause
approaches.
-
Clotting
disorders.
However, in
many cases, there may be no obvious cause.
How is menorrhagia diagnosed?
Menorrhagia is diagnosed on the basis of your symptoms. Your doctor may
examine you internally and take a cervical smear. You may also have a blood
test to check for anaemia and, possibly, hormone levels.
If necessary, you will be referred to a gynaecologist.
How is menorrhagia treated?
Treatment depends on the underlying cause. You may be prescribed hormones,
non-steroidal anti-inflammatory drugs, or tablets to help the blood clot
more easily. Surgery, for example, endometrial ablation, may be a
possibility. Although a hysterectomy will almost certainly solve the
problem, this should be viewed as a last resort.
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OBESITY
What is
obesity?
In layman's terms, obesity means very overweight, but, medically, obesity
means having a body mass index (BMI) of more than 30.
What is BMI?
BMI is a way of calculating whether your weight is in proportion to your
height. To calculate your personal BMI, divide your weight in kilograms by
your height in metres squared (that is, multiplied by itself). A BMI of
between 20 and 25 is regarded as healthy, a BMI between 25 and 30 is
regarded as overweight, and a BMI of greater than 30 is regarded as obese.
Why do people become obese?
The simple answer is that they have taken in more dietary calories than
their body needs. These extra calories have been stored as fat. However,
some people do seem to put on weight more easily than others, and the
tendency to become overweight seems to depend on several factors such as
genetics, your age, whether you smoke, the amount of exercise that you take,
and the proportion of fat in your diet. About 2% of obese people have a
medical problem that causes their obesity.
Is obesity dangerous?
Being obese puts you at greatly increased risk of developing heart disease,
diabetes, osteoarthritis, and certain cancers. It is also unsightly.
What can I do to lose weight?
Dieting alone is not the answer. You need to make a few lifestyle changes,
including:
-
Increase
your level of physical activity. You could try taking a brisk walk daily,
or join a gym or a swimming club. Many gyms run special sessions for
people needing to lose weight.
-
Cut down
on your fat intake, and eat more high fibre, high carbohydrate food, and
fresh fruit and vegetables. Beware of hidden fat in many processed and
pre-prepared foods.
-
Reduce
your alcohol consumption. Alcohol is loaded with calories.
-
If you
must nibble, nibble a piece of fruit or a carrot.
Accept that
you may need help to lose weight. If you are not sure what foods are best to
eat, ask your doctor to refer you to a dietician. Many people find the moral
support of a slimming club, such as WeightWatchers, very helpful.
Diet pills, liquid meals, and special food supplements may help you lose
weight in the short-term, but are not the answer to maintaining a healthy
weight in the long-term.
Useful source of information:
WeightWatchers. Telephone: 0345 123 000 or look in your local paper or phone
book for details of your nearest branch. Website:
http://www.weightwatchers.co.uk
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OSTEOARTHRITIS
What is
osteoarthritis?
The term 'osteoarthritis' literally means joint damage and inflammation. In
this type of arthritis, the smooth lining of the joints (cartilage) becomes
damaged and deteriorates, causing the underlying bone to thicken and become
distorted, sometimes leading to bony overgrowths known as osteophytes. The
joint becomes swollen, inflamed, and painful. Although all joints can be
affected, the most commonly affected are the knees, hips, spine (when it is
known as spondylosis), fingers, and big toes. With the exception of the
fingers, these are all weight bearing joints.
What causes osteoarthritis?
Osteoarthritis is commonly regarded as a disease of 'wear and tear', as it
rarely affects anyone under the age of 40. Other risk factors include being
overweight, and a previous joint injury. Some occupations may put extra
stress on certain joints, for example, professional footballers are known to
be at particular risk of developing osteoarthritis of the knee.
Heredity is known to play a part in a form of osteoarthritis known as nodal
osteoarthritis, which commonly affects the hands. Some rarer types of
osteoarthritis are caused by hereditary disorders of collagen - an essential
component of cartilage.
What are the symptoms of osteoarthritis?
-
Joint
stiffness and pain, worse after exercise and at the end of the day.
-
Backache.
-
Joint
swelling.
-
Reduced
range of movements in the affected joint.
How is
osteoarthritis diagnosed?
A diagnosis may be made on the basis of the symptoms, although x-rays and
possibly an MRI scan will help confirm the diagnosis. There is no blood test
for osteoarthritis, but blood tests may be performed to exclude other types
of arthritis.
How is osteoarthritis treated?
-
Drugs,
such as painkillers or non-steroidal anti-inflammatories. Some of these
can be bought over-the-counter without a prescription. Ask your pharmacist
for advice.
-
Physiotherapy.
-
Steroid
injections into the joint.
-
Joint
replacement for severe disease of the hip or knee.
Is there
anything I can do to help myself?
-
Maintain
a healthy weight.
-
Take
regular exercise. Swimming is excellent.
-
Wear
shoes with shock-absorbing soles, such as trainers.
-
Don't
overdo it. If you have a lot of housework or gardening to do, do it in
short bursts with short breaks in between.
-
Think
about modifying your home to minimise stress on your joints. An
occupational therapist will be able to advise you on this, and may be able
to arrange special equipment if necessary.
-
Some
people find alternative therapies helpful. Acupuncture, in particular,
seems to have a pain relieving effect.
Useful
sources of information:
Arthritis Research Campaign, PO Box 177, Chesterfield, S41 7TQ. Website:
http://www.arc.org.uk
Arthritis Care, 18 Stephenson Way, London NW1 2HD. Telephone 0808 800 4050
(12md - 4pm Monday to Friday). Website:
http://www.arthritiscare.org.uk
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PAEDIATRIC – BEDWETTING
Why do
children wet the bed?
Although some children do have a medical condition that causes them to wet
the bed, for the vast majority there is no obvious reason. It is likely that
some children simply do not have the bladder capacity to last through the
night, but also sleep so soundly that they do not wake up when their bladder
is full. Bedwetting is also more likely to occur if the child is under
psychological stress, for example, if there are problems at home or at
school.
How common is bedwetting?
It is estimated that nearly 20% of five and six year-olds, and 1% of
teenagers wet the bed, at least occasionally. Boys are more likely to be
bedwetters than girls.
What can I do to help?
Firstly, it is important that you don't get angry or upset with your child.
Children have little control over their bedwetting, and making them feel
guilty may make matters worse. Although the problem usually resolves with
time, the following tips may help:
-
Don't let
the child have a drink within an hour of bedtime.
-
Make sure
your child empties his/her bladder before going to bed.
-
Keep a
potty near the bed and leave a nightlight on.
-
Protect
the bed with a waterproof mattress cover.
-
Trainer
pants may be helpful for younger children.
-
'Lift'
your child onto the potty or toilet when you go to bed.
-
Older
children may respond to the use of a 'star chart'.
-
Praise
your child if he/she has a dry night.
-
Ask your
health visitor to lend you a bedwetting alarm.
Your health
visitor may be able to offer alternative advice if the above don't help.
When should I take my child to see a doctor?
-
If your
child's urine smells 'fishy' or if he/she says it hurts to pass urine.
-
If your
child seems to be passing more urine than usual, both day and night.
-
If your
child suddenly starts wetting the bed, after previously being dry.
-
If your
child is still wetting the bed after the age of six.
Useful
source of information:
ERIC (Enuresis Resource and Information Centre), 34 Old School House,
Britannia Road, Bristol BS15 8DB. Telephone: 0117 960 3060
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PAEDIATRIC – BRONCHITIS
What is
bronchitis?
It is the medical term for inflammation of the lungs, which is the condition
that people are usually describing when they say that a cold has “gone down
on to the lungs”. Indeed, bronchitis usually follows another infection, such
as a cold, sore throat, or the flu. Bronchitis causes the tiny air passages
inside the lungs to become inflamed and so swell, which reduces the amount
of air that your child can breathe in. In addition, the infection causes
mucous to build up inside the lungs (mucous is normally produced inside the
lungs to stop them drying out), and this can also make breathing difficult.
What are the symptoms?
-
Wheeziness and difficulty breathing - a result of the swollen air tubes
and the excessive amounts of mucous inside the lungs.
-
Dry,
hacking cough - the mucous irritates the inside of the lungs, and so your
child coughs to remove the irritation.
-
Vomiting
- sometimes occurs after mucous that has been coughed up is then
swallowed, or after a particularly severe coughing fit.
-
Raised
temperature - a raised temperature is one that is 38 degrees C/ 100
degrees F or over.
-
Difficulty sleeping because of other symptoms.
Is
bronchitis serious?
Not usually in children over a year old. However, babies under a year old
may experience severe breathing problems and may even need to be
hospitalised.
What should I do?
If your child is struggling to breathe or his or her skin is tinged with
blue, this should be treated as an emergency and you should get medical
assistance immediately. You should also contact the doctor if the infection
seems to be getting worse. If your child seems hot or has a raised
temperature, keep him or her cool (not too many clothes or covers). Also
give him or her infant paracetamol mixture to help reduce the temperature as
well as soothing your child and helping him or her to rest.
If your child is coughing a lot, try and encourage him or her to bring up
the mucous (usually called phlegm) instead of swallowing it - this will ease
his or her breathing. If your baby is too young to understand, then place
him or her over your lap during coughing fits, and pat his or her back to
help loosen the phlegm. Clear your baby's mouth of the phlegm to stop him or
her choking. Prop your child up on pillows to help him or her breathe at
night.
Keep your child warm, and try and keep him or her quiet and calm - crying or
running around will make his or her breathing more difficult and the
coughing fits more likely and more severe. Make sure your child is drinking
fluids (plain water or fruit juice are best) frequently so that he or she
does not become dehydrated.
Additional Patient Support Sheets: Healthy Medicine Cabinet, When to Call
the Doctor
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PAEDIATRIC – CRADLE CAP
What is it?
Cradle cap is a harmless scalp condition common in newborn babies. Your baby
may have a mild case of flaky, dry skin that looks like dandruff, or a more
severe case marked by thick, oily, yellowish, scaling, or crusting patches.
It can also appear in the eyebrows, around the nose, and behind the ears. It
is not caused by poor hygiene.
Who gets it?
Cradle cap usually appears anytime between two weeks to three months after
birth, although it has been known to affect children up to the age of three
years. It tends not to be a problem after a baby reaches six or seven months
old.
What causes it?
Cradle cap is a form of seborrhoeic dermatitis, a skin condition in which
the oil glands are stimulated by adult hormones. The glands produce too much
oil, which turns into oily patches, and then dries and flakes off. Some
doctors think that the extra hormones a mother produces and passes to her
baby during childbirth causes the oil glands to over-produce.
What can be done about it?
The best way to remove the scales is to rub oil, such as baby oil or olive
oil into your baby's scalp every day and leave it there for about 15
minutes. This will help to soften and loosen the scales. Then wash the scalp
with mild shampoo - do not use anti-dandruff shampoo without consulting your
doctor. Do not rub your baby's scalp hard when you are shampooing - the
loose scales should wash away easily, although some may need further
softening before they can be removed. Brushing the hair regularly with a
soft-bristled brush will also help to loosen the scales, and will help
prevent the build up of cradle cap in the first place.
When the hormones in your baby's body level out after the early months, the
condition should go away.
If the scalp becomes very inflamed, or the cradle cap does not seem to be
getting better, your doctor may prescribe a mild corticosteroid cream.
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PAEDIATRIC – NAPPY RASH
What is
nappy rash?
Nappy rash is a skin condition that occurs in the nappy area. It is very
common and ranges in severity from a slightly red bottom to an angry rash
with broken skin and blisters.
What causes nappy rash?
-
Irritation of the skin from contact with urine and faeces.
-
Reactions
to washing powder/liquid if your baby wears cloth nappies.
-
Reactions
to bathing products.
-
Thrush.
-
Eczema.
What can I
do about nappy rash?
-
Change
your baby's nappy frequently.
-
Change
soiled nappies immediately after your baby has a bowel movement.
-
Clean
your baby's skin thoroughly with a gentle cleansing product. Wipes are not
suitable if they contain alcohol.
-
Apply a
suitable protective cream to your baby's bottom. There are a number on the
market, so it is a case of experimenting to find one that you like and
which suits your baby. Consult your pharmacist for advice.
-
Don't use
talcum powder.
-
Let your
baby go bare-bottomed as often as possible.
-
If you
use cloth nappies, try changing your washing powder/liquid. Use
non-biological products and don't use fabric conditioner. Where possible,
line dry nappies.
-
Use plain
water for your baby's bath.
If the
nappy rash does not clear up, consult your health visitor for advice. If the
cause is likely to be thrush or eczema, she will also be able to advise on
whether you need to take the baby to see the doctor.
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PAEDIATRIC – OTITIS MEDIA
What is
otitis media?
It is the medical term for inflammation of the middle part of the ear. The
ear is divided into three segments - the middle part, which is fluid filled
and lies behind the ear drum, is connected to the throat via the Eustachian
tube. In children, the Eustachian tube is relatively short, so any
infections in the throat, such as if your child has a cold, sore throat, or
tonsillitis, can easily travel to the middle ear. The infection can block
the Eustachian tube, preventing fluid and mucus in the middle ear from
draining away as normal. This causes the fluid in the middle ear to build
up, leading to pressure in the ear and earache. If the trapped mucus is not
released, it usually increases and becomes sticky, leading to glue ear.
What are the symptoms?
These usually follow a cold or throat infection:
-
Severe
pain in the ear - babies may rub or tug at their cheek or ear, young
children may be unable to locate the pain precisely
-
A raised
temperature - over 37 degrees C / 98.4 degrees F
-
Loss of
hearing
-
Discharge
of pus - about 4% of otitis media cases result in a burst ear drum; the
ear drum usually heals by itself.
Is otitis
media serious?
It can sometimes cause hearing loss if it is severe and occurs in both ears.
However, it is not serious in the vast majority of cases.
What should you do?
Earache is often worse at night when the child is lying flat - your child is
may find it difficult to get to sleep or may wake up distressed and in pain.
Sitting up your child will help relieve the pressure in the middle ear, and
infant paracetamol mixture will help to relieve the pain. If there is no
discharge from the ears, then a little warm oil or ear drops poured in to
the ear may help to relieve the situation; however, it is best to check with
your doctor first. Warmth often helps to relieve the pain - place a warm hot
water bottle wrapped in a towel next to your child's ear. If your child is
under a year old, do not leave him or her alone with a hot water bottle in
case he or she overheats.If your child continues to have pain, has a high
temperature, or there is a discharge from the ear(s), contact your doctor.
Make sure no water enters the ear when your child is having a bath or
shower, and don't let him or her go swimming until two weeks after the
infection has cleared up completely.
What might your doctor do?
Your doctor may be prescribe antibiotics to clear up the infection. If your
child seems deaf after an episode of otitis media, your doctor will probably
check him or her again after a month or two in case he or she has developed
glue ear. If your child frequently suffers from glue ear, your doctor may
refer him or her to an ENT specialist, who may recommend that grommets
(small plastic tubes) are inserted in each ear. These help the fluid to
drain away easily. The grommets usually fall out after a few months once the
ears are healthy again.
Additional Patient Support Sheets: Earache, Taking Antibiotics
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PAEDIATRIC – TEETHING
What is
teething?
This is the term used when a baby's first set of teeth are coming through.
The first tooth usually comes through at about the age of six months, and
the whole set of 20 is normally complete by the age of two years. There is,
however, some variations in these times.
What are the symptoms?
Many babies teeth without any problems, while some find it a very unhappy
experience. When a tooth is about to erupt, symptoms include:
-
Irritability and fretfulness.
-
Crying
and 'clinginess'.
-
Difficulties settling and sleeping.
-
Hot
cheeks - and an inflamed hard lump on the gum where a tooth is about to
come through.
-
Rubbing
or scratching cheeks, ears, or neck.
-
Dribbling
- more saliva than normal is being produced.
-
Biting
and chewing - desire to bite on anything, such as fingers, that he or she
can get into the mouth.
Any other
symptoms, such as a high temperature, nappy rash, or diarrhoea, may be the
symptoms of an underlying illness. Consult your doctor if you are concerned.
What can you do?
-
Give your
baby something suitable to chew, for example, a piece of apple or a stick
of carrot. Chill them first in the fridge. Because of the possibility of
choking, do not leave him alone with food.
-
A
teething ring may help, particularly if you keep it in the fridge.
-
Try
rubbing your baby's gums with a clean finger or commercial painkilling gel
(follow the instructions on the box).
-
Infant
paracetamol can be given if your baby is obviously in pain. Follow the
instructions as regards dosage.
-
If your
baby temporarily seems to have 'gone off' his food, don't worry. Babies
rarely lose their appetites for long.
If you have
any concerns about your baby's teething, consult your health visitor.
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PAEDIATRIC – UTRICARIA
What is
urticaria, or hives?
Also known as hives or nettle or heat rash, it is a particular type of skin
rash. It is easy to recognise - the rash consists of white and raised lumps
against red inflamed skin. The lumps can be tiny pimples or centimetres
across, and can merge to form large raised lumps. The lumps are usually very
hot and itchy. The rash usually appears only in certain areas of the body,
although in severe cases they can cover the entire body.
What causes it?
There are a variety of reasons, such as:
-
Skin is
irritated by contact with certain plants or insects, such as stinging
nettles or primulas; wasps or bees
-
Reaction
to something that has been eaten, frequently strawberries, shellfish,
eggs, or nuts
-
Reaction
to certain drugs
-
The
skin's response to cold or sunlight, or to sweating bought on by exercise
or heat
Is it
serious?
Not usually. However, in rare cases the rash occurs in or around the mouth,
and is accompanied by swelling. In this instance, it can be very serious as
the air passage may be blocked by the swelling of the tongue or the throat.
If this happens, get medical assistance immediately - medically, this is
known as angioneurotic oedema
What can you do?
If you suspect that your child is reacting to certain foods, keep a note of
each time the rash appears. Exclude the food from his or her diet for a week
or two and then reintroduce a small amount of it and check if the rash
appears. If you think it may be caused by a particular drug, discuss things
with your doctor - details about allergies to drugs, especially penicillin,
is something your child should keep on him or herself at all times in case
of accidents. If circumstances appear to trigger the rash (this is quite
rare), such as sudden exposure to strong sunlight, try building up to it
gradually or trying different ways of minimising the effect. In the case of
heat rash, a daily beta carotene supplement can help in some cases, although
always check with your doctor or health visitor before giving any vitamin
supplements to children.
If your child reacts badly to the stings of bees or wasps, then he or she
should try and avoid eating sweet things (ice cream, lollies, jam - the
insects love them) outside in summer, and should be very wary of being
stung. However, try and teach your child that moving suddenly as a wasp or
bee comes near is often counterproductive - scared insects are the ones that
are most likely to sting and moving suddenly and shouting startles them. So
your child should slowly and calmly move away from the insect, and try not
to startle it. Any nests and hives in the vicinity of the house should, of
course, be removed promptly by professionals, preferably when your child is
not at home.
Urticaria often clears up of its own accord as the child grows up. However,
this is not always the case if it is caused by an allergic reaction to food
or drugs, when increased sensitivity can occur with each exposure. Once your
child has the rash you should -
-
Apply
calamine lotion to the rash
-
Make sure
that clothing isn't irritating the skin any further
-
Give your
child a tepid bath to relieve the itching
-
Consult
your doctor if the rash lasts for several days or is very severe
What might
your doctor do?
If your child's rash is caused by an allergic reaction to certain substances
or to the stings or bees or wasps, your doctor may prescribe anti-histamine
tablets or medicine to relieve it.
Useful souce of informaytion:
Food Allergy Association, 4 Gorse Bank Close, Rock Road, Storringham,
Pulborough, W Sussex BN16 4BW
Additional Patient Support Sheets: Hayfever, Food Allergies
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PAEDIATRIC – WHEN TO CALL THE DOCTOR
A baby,
like any other young mammal, often reacts quite alarmingly to even small
problems, and it can be very difficult, especially when you are a first-time
parent, to know when to call the doctor. There are some circumstances when
medical help should be sought immediately, and these will usually be obvious
(see When is it an emergency? on accompanying sheet). However, there are
other times when you may be unsure about the severity of the illness and
whether you should contact the doctor or not, and this sheet has been
designed to help you decide. This sheet is only intended as a guide,
however. You know your baby better than anyone and if you feel anxious about
his or her health, but can't quite put your finger on what' wrong, then you
should contact the doctor - your doctor would much rather be safe than
sorry.
When might symptoms be significant?
There are a number of different symptoms that indicate that a baby is ill;
the severity and combination of symptoms are the significant factors in
determining if the doctor should be called:
-
Crying -
even very fretful babies are rarely seriously ill - most crying is an
indication of discomfort or loneliness. However, it could be significant
if your baby's crying is unusual or different from normal, including cries
that are high-pitched, weak, moaning, or painful sounding. If high-pitched
moaning cries are combined with purpura (see Rashes) and a temperature
(see Temperature), then contact the doctor immediately.
-
Fluid &
food intake - it is significant if your baby refuses all food or his or
her fluid intake is less than half the normal intake over a 24 hour
period, especially if your baby is also less alert than usual (see
Drowsiness & alertness) or if the fontanelles (soft places in your baby's
skull) have dipped.
-
Vomiting
- most babies bring a little bit of milk back up after a feed, and this is
perfectly normal. However, it may be significant if at least half the feed
is vomited after three or more feeds in a row, if the vomit is
green-coloured, or if the vomiting is accompanied by persistent diarrhoea.
-
Dry or
bloody nappies - it is significant if your baby's nappy is noticeably
drier than normal over the course of three or more changes or if there is
a large quantity of blood in the nappy (not just a tiny amount).
-
Diarrhoea
- it could be significant if your baby has diarrhoea for six hours or
more, especially if he or she also has a raised temperature (see
Temperature).
-
Drowsiness & alertness - even the most placid baby is usually aware of
what is going an around him or her. If your baby is noticeably drowsy, is
not watching you, and is not responding to anything, then it is
significant, especially if other symptoms are present.
-
Floppiness - some babies are more relaxed than others, but you will know
how cuddly, relaxed, firm, and strong your baby's body normally is, and if
your baby's body is much more floppy than normal, it could be significant.
This is particularly so if accompanied by a raised temperature (see
Temperature), purpura (see Rashes), and a high-pitched, moaning cry (see
Crying).
-
Breathing
problems & wheezing - It is significant if your baby is having problems
breathing (the bottom of the chest will dip at every breath), or if he or
she is wheezing (whistling sort of noise) when breathing out, especially
if he or she is also pale (see Paleness & poor circulation) with blueing
around the lips or is red in the face.
-
Paleness
& poor circulation - some babies are naturally pale, but if your baby's
body is much paler than normal then this is significant, especially if his
or her nails are tinged slightly blue.
-
Rashes -
if your baby has a rash that covers a large area of his or her body, if
the rash is weeping and sore, or if the spots don't vanish when pressed
with the side of a glass (known as purpura) then this is significant,
especially if your baby has also got a high temperature (see Temperature)
and is make a high-pitched, moaning cry (see Crying).
-
Temperature - a raised temperature is over 38.3 degrees C (100.8 degrees
F). It is especially significant if combined with other symptoms, such as
a stiff neck, high-pitched moaning cries, or vomiting and diarrhoea, if it
drops and then rises again, if it is maintained for three days or more, or
if your child has a raised temperature and has had a fit in the past. A
low temperature - below 35 degrees (95 degrees F) - when accompanied by
clammy cold skin, drowsiness, and lack of alertness is also significant.
-
Hernia -
some young babies develop hernias (soft swelling) near the navel or in the
groin. All babies should be checked by the doctor if they develop a
hernia, although most hernias do clear up by themselves.
When is it
an emergency?
If your baby experiences any of the following he or she requires urgent
medical assistance:
-
Stops
breathing, or his or her skin turns blue
-
Cannot be
roused or woken
-
Is very
unresponsive and isn't aware of what is going on around him or her
-
Has
glazed eyes and isn't focussing on anything
-
Has a
deep wound that is bleeding badly
-
You
suspected he or she has a fractured or broken bone
-
Has
swallowed or eaten drugs, chemicals, or anything poisonous
-
Has been
bitten by a snake or animal
Useful
sources of information:
Baby Check Ltd, PO Box 324, Wroxham, Norwich NR12 8EQ Tel: 01603 784400
For a copy of the Department of Health's excellent booklet Baby Check.
£8.95, including a digital thermometer
BM CRY-SIS, London WC1N 3XX Tel: 0171 404 5011 For parents under stress
because of a child who continually cries. Will give you a local number to
ring for support
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PELVIC FLOOR EXERCISES
The pelvic
floor forms a firm base to the pelvis. It is made up of muscle layers
forming a sling that supports the pelvic organs. These muscles can weaken
with age, or can be damaged following childbirth. Exercising these muscles
can strengthen them, helping to prevent impotence and incontinence as well
as preventing prolapses. Pelvic floor exercises are sometimes called “Kegel”
exercises.
How to do pelvic floor exercises:
Sit, stand or lie with your legs slightly apart. Tighten your back passage
as if you are trying to stop yourself passing wind. Count to four and let
go.
In the same position, tighten the muscles around the base of the bladder as
if you are trying to stop yourself passing urine. Count to four and let go.
If you have problems identifying which muscles these are, wait until you are
actually passing urine, then try to stop the flow. Another way to identify
the muscles is to imagine you are trying to hold on to an imaginary tampon
that is slipping out.
Some people find it helpful to imagine that the muscles of the pelvic floor
are a 'lift'. Normally, the lift is on the ground floor. Tighten the muscles
in stages, going up to the first and then the second floor. As you get more
experienced, try going up to the third floor. Loosen the muscles slowly to
return to the ground floor. Relax all your muscles and go down to the
basement. Now come back to the ground floor.
Pelvic floor exercises should be done at least four times a day. Some people
find it useful to place coloured stickers in strategic places around the
house to remind them to do them. However, if you have just had a baby, ask
your midwife for advice on how often you need to do them. If you have
continence problems, your GP or health visitor can advise you, or you may be
able to consult a specialist nurse continence advisor who will also be able
to check that you are doing them correctly.
For further information on incontinence, see our patient advice sheet
entitled 'Incontinence'.
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PRE-MENSTRUAL SYNDROME
What is
Premenstrual Syndrome (PMS)?
Most menstruating women experience some kind of physical or psychological
change in the week or two before their period begins which disappears once
their period has started. If symptoms restart after ten consecutive
symptom-free days, a diagnosis of PMS can be made. For most women the
symptoms are mild, however, for a small proportion, the symptoms are severe
and can affect their daily life.
What are the symptoms?
Very many symptoms are recognised, although most women experience only a
handful. The most common are: -
-
Irritability and mood swings - anger, rage, tension and depression.
-
Fluid
retention - bloating and breast tenderness.
-
Headaches
and sometimes migraines.
-
Muscle
cramps - backache, lower abdominal pain or tenderness.
-
Clumsiness.
-
Tendency
to daydream and poor concentration.
-
Intense
sensitivity and a heightened awareness.
What causes
Premenstrual Syndrome?
The cause is not known. Most doctors believe that it is linked to the
fluctuating levels of female hormones that are experienced following
ovulation; this may explain the bloating that occurs. It is possible that
PMS sufferers may have a lower level of a chemical called serotonin in their
brain and this would explain the irritability, depression and mood swings
experienced. It is not thought to be caused by a hormone deficiency.
What treatments are available?
Treatment will depend on the nature of the symptoms and their severity.
There is much that can be done to gain relief.
For many
women, simple changes to their diet and lifestyle, such as reducing alcohol
and caffeine intake and smoking, all help to make the symptoms more
bearable. Many women report craving for sweet or starchy (carbohydrate)
foods just before their period is due. Eating carbohydrates helps relieve
many symptoms by increasing serotonin levels. However, it must be remembered
that complex carbohydrates like fruit and wholemeal bread are better than
simple carbohydrates such as sweets and biscuits, as these are likely to
cause the blood sugar level to rise and a feeling of shakiness and
irritability to follow.
Being
active and exercising regularly helps to keep the hormones in balance.
Aerobic, non-weight-bearing exercise such as swimming, cycling or brisk
walking is most appropriate. Stress can increase the frequency and intensity
of the symptoms. Anything that helps relaxation such as yoga or meditation
will help relieve symptoms.
Some
studies suggest that capsules of Evening Primrose Oil alleviate
pre-menstrual breast pain. Vitamin B6 (pyridoxine) may help mood swings.
Diuretics (water tablets) may give relief for ankle swelling, but will not
effect abdominal bloating as this is caused by muscle distension in the
bowel.
In some
cases, antidepressants may be helpful
The
Combined Oral Contraceptive Pill (COC) is often prescribed in PMS especially
if contraception is required. It is believed to help by stopping ovulation
and reducing the body's natural fluctuation in the hormones thought to be
responsible for PMS. It is available by free prescription. Oestrogen patches
can suppress ovulation and reduce hormonal fluctuations. Scientific evidence
supports the use of oestrogen, but it can be obtained only on prescription.
In severe and difficult to treat cases LHRH analogues (Zoladex, Synarel) are
used, but these are potent, expensive drugs.
For a small
minority of women, surgical removal of the ovaries is the only measure that
will allow a normal existence free of PMS.
Useful Source of Information:
National Association for Premenstrual Syndrome, 7 Swift's Court, High
Street, Seal TN15 0EG. Telephone: 01732 760011. Website:
http://www.pms.org.uk
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SCHIZOPHRENIA
What
is schizophrenia?
Schizophrenia is a serious mental illness, affecting about one in a hundred
people in Britain today.
What are the signs and symptoms?
Schizophrenia has nothing to do with 'split personality', although the word
means 'split mind'. It is as if there is a split between the mind and
everyday life. If you have schizophrenia, you may feel as if you are
experiencing the world in a different way from everyone else. You may feel
as if you have lost control over your thoughts and actions, or as if someone
else is controlling them. You may hear voices which sound so clear and real
that it seems impossible they are actually in your own mind. You may feel
like replying to them or shouting at them.
Your brain may interpret the world differently from other people's; you may
feel that you have a special role or that some things have a special
significance which other people cannot understand. You may find everyday
life an effort. It can be difficult to get up in the morning and to mix with
people. You may feel better staying in your room.
What causes schizophrenia?
The cause is not really known, although it sometimes runs in families.
Stress is not a cause, but a stressful event may trigger an attack. Like
everyone else, people with schizophrenia may be of high or low intelligence
and it is rare for them to be violent - in fact many are original, talented
people.
What can be done?
Schizophrenia cannot yet be cured but it can be treated and controlled.
Drugs can be given which will gradually suppress the 'voices' and feelings
of lost control. There are many people who can work with you to help you
return to a normal life - people like your consultant, your GP and your
community psychiatric nurse. There may be times when you need treatment in
hospital, but as you recover from an episode you may find it helpful to
attend a day centre.
What can I do to help my recovery?
-
Do keep
taking your medication. It is tempting to stop taking it when you feel
better, especially as it may give you some side effects, but unfortunately
stopping it will lead to a return of the symptoms.
-
Don't
take any other drugs unless they have been prescribed for you; they may
not mix well with your own medication. Do avoid drugs like alcohol or
cannabis, because they are likely to make your symptoms worse.
-
Try to
avoid stress if possible. You may find it useful to talk to your doctor or
nurse about what is stressful in your life.
-
Eat a
good diet and take care of yourself. You may not feel like it during an
attack so it pays to eat well when you are able.
-
Don't
neglect your supporters. Having a family or small group of friends around
you to give support during the difficult times will make a big difference
to you. If you have no close friends, why not contact one of the
organisations listed below, who will understand your situation.
-
Think
positive. Many cases of schizophrenia clear up, and even if yours isn't
one of them, it is very likely you will be able to continue a normal,
productive life.
Useful
sources of information
MIND (National Association for Mental Health)
Granta House, 1519 Broadway, Stratford, London E15 4BQ
http://www.mind.org.uk/
National Schizophrenia Fellowship (NSF)
30 Tabernacle Street, London EC2A 4DD
Telephone: 020 7330 9100
http://www.nsf.org.uk/
SANELINE
National helpline run by the organisation SANE, to offer help and advice to
anyone coping with mental illness.
Telephone: 0345 67 80 00 (2pm - 12mn)
http://www.cab.org.je/10050401.htm
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SHINGLES
What is
shingles?
Shingles, also known as Herpes Zoster, is a painful rash of small yellow
blisters, which spread over an area, dry up, and form scabs. The rash
spreads as a band around one side of the body. It can also affect the face,
especially on the brow and round the eye.
Who gets shingles?
You can only get shingles if you have already had chickenpox (also called
varicella). Shingles can occur in both adults and children, but is more
common in the over 50s.
What causes it?
Once you have had chickenpox, the virus that causes it can lie dormant in
the nerves of your body without doing any harm. However, if reactivated,
this virus can cause shingles. An attack of shingles often occurs when
people are run down, or under stress.
What are the symptoms?
The first sign is a burning sensation or feeling of tenderness on the nerve
paths along which the virus is travelling. However, some people just feel
slightly unwell. Two or three days later, a red spotty rash appears. These
spots blister rapidly. After one or two weeks, these blisters dry up and
form scabs.
The rash only affects the side of the body served by the affected nerves and
is sometimes extremely painful - some people can't even bear their clothes
to touch the rash. The pain can continue after the spots have gone, for
weeks or even months, and is called post-herpetic neuralgia, but this is not
common.
If your eyes or the side of your head are affected, you should see a doctor
urgently as shingles can cause blindness.
How is shingles treated?
A light dusting powder such as zinc oxide or calamine lotion can help to
soothe the irritation. Alternatively xylocaine ointment can be bought over
the counter and spread on the area. Other analgesic creams are available on
prescription.
The only treatment for shingles itself is anti-viral drugs. There are
several of these, but they work best when started within three days of an
attack starting. These drugs are only available on prescription.
If post herpetic neuralgia persists, sedatives and analgesics can be
prescribed for the pain. Carbamazepine or amitriptyline may be prescribed in
severe cases.
Useful source of information:
Shingles Support Society, 41 North Road, London N7 9DP. Send an SAE and
donation for self-help advice and drug treatment information. Website:
http://www.astrabis.co.uk/sites/herpesvirusesa/shingles.htm
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STROKE
What is a
stroke?
A stroke is a sudden attack of weakness or paralysis affecting one side of
the body.
What is the cause?
A stroke can be caused by a blood clot stopping the flow of blood in the
brain, or by a burst blood vessel in the brain causing bleeding into the
surrounding cells. A blood clot can develop inside a blood vessel (a
thrombosis), or may be carried in the bloodstream from another part of the
body (an embolism).
What are the symptoms?
The symptoms depend on which part of the brain is damaged, but most
commonly, one side of the body is affected by a loss of sensation, leading
to weakness or paralysis of limbs. A person may have problems walking, or
lose balance and co-ordination. They may also become confused or dizzy, and
have difficulty in speaking or understanding speech. Stroke can also lead to
difficulty in swallowing and visual disturbances.
What are the risk factors?
Risk factors include:
-
Smoking:
Smoking can cause blood vessel damage and thickening of the blood, both
increasing the risk for stroke.
-
Age: The
older you are, the more likely you are to have a stroke.
-
Men
suffer more strokes than women.
-
High
blood pressure, high cholesterol, and diabetes, which can all cause blood
vessel damage.
-
Family
history.
-
Heart
disease, including atrial fibrillation.
-
Heavy
alcohol consumption.
-
Obesity.
What is the
treatment?
A stroke causes permanent damage to the brain cells affected. However,
sometimes enough cells are unaffected for the patient to recover mobility.
Some people may have a temporary stroke known as a 'transient ischaemic
attack' in which symptoms disappear completely within the first 24 hours.
However, some patients do not recover fully from a stroke. In very rare
cases, surgery will be used to prevent another stroke or to repair vascular
damage or malformations in and around the brain. Rehabilitation can be
helped by physiotherapy. To reduce the risk of further strokes, the patient
may be given medication, e.g., for high blood pressure, but should also stop
smoking, reduce alcohol intake and lose weight if necessary.
Useful sources of information:
-
The
Stroke Association. Helpline: 0845 30 33 100. Their website on
http://www.stroke.org.uk
offers a huge list of contacts in all regions of the UK. For a free copy
of their magazine, 'Stroke News', ring the editor on 020 7566 0327
-
Stroke
Family - this is a website run by and created for the victims of stroke
and their families on
http://www.strokefamily.org
-
National
Institute of Neurological Disorders and Stroke (NINDS). This is an
American website but it does offer interesting and useful information
about the latest research and news on
http://www.ninds.nih.gov
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TEENAGE GIRL
There are some fundamental facts of life
about which you should be aware:-
Teenage love affairs are gut wrenchingly
powerful (in Romeo and Juliet Shakespeare made Juliet 14 because this is the
age when the passions are most dangerous) but sadly, in almost all cases,
short lived - weeks or months as a rule.
If you want to have sex think about it,
think about it again, and then think about it one more time.
Sex and the Girls Body.
If you have sex at a young age then this
can have bad health effects later on. There is clear evidence that early sex
is linked to cancer in later life. If you use condoms, this can reduce the
risk.
Babies and Single Teenage Mothers.
Most teenagers who have a baby are very
soon a single mother. The father does not normally offer any real help.
As doctors we find that such women are
frequently depressed, upset, and can even find themselves resenting the
baby. "I wanted a baby so much, and now all it does is cry" is a sadly
familiar line. This is not good either for the mother or the baby.
Unless your parents are fully behind you
and willing to look after the baby while you continue your education or
develop your career, having a baby is likely to be a huge error.
Aids HIV and Safe Sex.
There are lots of Sexually Transmitted
Diseases, of which HIV is the best known and most serious. Apart from saying
no, condoms are the best protection are the best
protection against ALL sexually tranmitted diseases. Simple rule - no
condom, no sex. If he complains, kick him out of bed. I (the writer) am a
man and can tell you that yes, wearing a condom does reduce the feeling a
little, but sex with a condom is still a great pleasure. If he respects you
he will wear it. There is also of course the female condom, which is a fine
alternative.
If you do not wish to talk to your GP,
contact a local family planning clinic.
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TENNIS ELBOW
What is
tennis elbow?
Tennis elbow is inflammation of the tendons on the side of the elbow and the
forearm. Tendons are fibrous cords which join muscle to bone.
What causes tennis elbow?
Tennis elbow is usually caused by overuse of the arm, and despite its name,
it usually results from repeated movements of the arm in other ways, such as
washing windows, or using tools in a repetitive way. Playing tennis only
increases the risk if your training schedule is intense. The problem can be
triggered by sitting or standing in an awkward position while working, or
using badly-designed tools or equipment.
What are the symptoms of tennis elbow?
-
Pain and
tenderness on the outer site of the elbow. The pain is often worse when
lifting objects with the palm of the hand facing downwards
-
The area
may become swollen
-
Stiffness
around the affected joint.
How is
tennis elbow treated?
-
The
initial treatment is painkillers and/or anti-inflammatory drugs, and rest
-
If the
pain or inflammation does not get better in a few weeks your doctor may
suggest a cortisone injection
-
Physiotherapy is sometimes helpful.
What can I
do to help?
-
Lift
objects with the palm of the hand facing upwards
-
Some
people find that alternative therapies such as acupuncture may relieve the
symptoms
-
To
prevent injury make sure that the tools and equipment you use at work are
the right size for you, and try not to work in awkward positions
-
Seek
advice from a specialist sports' shop or qualified instructor about
appropriate sports' equipment, techniques, and a suitable training
schedule, and always warm-up and cool down properly when exercising.
Useful
source of information:
Health and Safety Executive. Telephone: 08701 545500. Website:
http://www.hse.gov.uk
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TINEA
What is
Tinea?
Tinea is the name given to a group of contagious fungal infections that can
affect the scalp, the body (particularly the groin), the feet (athlete's
foot), or the nails. These are common conditions in young people and adults,
and are usually referred to as ringworm. People can get ringworm from direct
skin to skin contact, by contact with the soil, or from pets and other
animals.
What are the symptoms?
A red itchy rash occurs in the spaces between the toes or a scaly patch
appears on the scalp. The infection on the body appears as a characteristic
ring of redness on the arm or leg, and it itches. Sometimes the red skin
furrows and becomes marked with ridges resembling chalked lines.
Common Tineal infections are:
-
Tinea
corpus: commonly affecting the chest, back arms or legs. It forms a red
ring around an area of white unaffected skin. It is common in children who
have close contact with animals.
-
Tinea
capitis: is also common among children and consists again of a red circle
around unaffected skin on the scalp. Hair may be lost and regrowth may be
patchy. In severe cases a swollen mass discharging pus, called a kerion,
may form.
-
Tinea
pedis: also called athlete's foot, is found as an itchy sore between the
fourth and fifth toes, that goes soggy and white and starts to crack and
peel. It spreads easily to other parts of the foot and to other people. It
occurs frequently in warm, sweaty feet.
-
Tinea
unguium: affects the toe nails especially if the person has athlete's
foot. The nails become thickened and white or yellow in colour. If
untreated, the nail will split and rise away from the nail bed, crumble
and be lost.
-
Tinea
cruris: or 'jock itch' is common in men, especially those who are sporty,
wear tight underwear, or who sit on plastic seats for extended periods of
time. It starts as small red spots on the inside of the upper thighs and
these spread to form an itchy, reddened, scaly patch.
What is the
treatment?
Topical antifungal creams can successfully treat the infection. It often
takes two or three weeks to control the fungus. Occasional cases may require
oral antifungal medicine or tablets as well. If a large kerion that is
discharging pus has formed, antibiotics may be prescribed. Toenail
infections can take as long as six months to treat.
What can I do to help?
-
Avoid
sharing hairbrushes, towels or other personal belongings.
-
Avoid
wearing tight clothing especially if it is synthetic.
-
Let the
air get to your skin and wear cotton or wool socks.
-
Wear
shoes that let your feet breathe. If you have athlete's foot then dust the
inside of your shoes and between your toes with special powder obtained
from the pharmacist.
-
Dry skin
thoroughly especially between the toes, and in the groin.
Prompt
treatment will prevent the fungus getting a hold.
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TRAVELLERS HEALTH – DVT
What is
deep vein thrombosis?
Thrombosis is the medical term for a blood clot inside the body. The term
'deep vein thrombosis' usually refers to a blood clot that forms in the deep
veins of the legs. It is also referred to as 'venous thrombosis' and can be
abbreviated simply to DVT.
What causes DVT?
DVT occurs when there is reduced blood flow in the lower limbs. The most
common cause of reduced blood flow is prolonged immobility. Other factors
that pre-dispose to DVT include:
-
Taking
oral contraceptives.
-
Pregnancy.
-
Heart
failure.
-
Recent
surgery.
What are
the symptoms of DVT?
Symptoms include pain, swelling and redness of the calf. A low-grade fever
may also be present.
Is DVT dangerous?
The danger of a DVT is that all or part of the blood clot may break off and
travel to the lungs. Clots that lodge in the lungs are referred to as
pulmonary emboli, and can be life threatening.
Are travellers at risk of DVT?
Travellers who remain immobile for a long time, for example, in an aeroplane
seat, are at risk of DVT. Air travel may also carry a slightly increased
risk in that the air inside the cabin is dry, and may contribute to
dehydration, which can further reduce blood flow.
What can I do to reduce my risk of DVT while flying?
On flights lasting six hours or more, or on multiple short-haul flights:
-
Avoid
alcohol and caffeinated drinks.
-
Drink
plenty of non-alcoholic fluids.
-
Do not
cross your legs while seated.
-
Wear
loose-fitting clothing.
-
Walk
around the cabin as often as possible, ideally at least once every
two-to-three hours.
-
Do leg
and foot exercises while seated. For example, try 'circling' each ankle,
first in a clockwise, and then in an anticlockwise direction.
-
Follow
any specific advice on prevention given by the airline.
-
If you
have a history of a previous DVT, or any other risk factors, consult your
doctor for advice on prophylaxis.
What about
aspirin for prevention of DVT?
Although some doctors do recommend taking half an aspirin before a long
flight to reduce the risk of DVT, there is little evidence that it actually
works. Some people, for example asthmatics, and those on certain drugs,
should not take aspirin.
How is DVT treated?
DVT is treated with anticoagulants. They may be given by injection
initially, and then in tablet form. However, the best treatment is
prevention.
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TRAVELLERS HEALTH – SAFER SEX &
STD’s
What does
safer sex mean?
You are having safer sex when you have taken sensible precautions against
sexually transmitted diseases.
What do I need to do?
The most important element of safer sex is always, without fail, using a
condom. Whether you are male or female, you should always carry new and
undamaged condoms with you if there is any chance you may be going to have
sex. The more partners your partner has had the greater the risk that they
are infected with a sexually transmitted disease. It is usually impossible
to tell when someone has a sexually transmitted infection.
Why is it important for travellers?
Safer sex is important for everyone, but it is in some ways an especially
significant issue for travellers because:
-
Many
people find they are more likely to have casual sex while they are away
from home. This is because people lose their inhibitions, particularly
when they are on holiday. The more partners you have, the greater the
risks.
-
In many
areas of the world, particularly Asia and Africa, a high proportion of
prostitutes are HIV positive and many also carry other sexually
transmitted diseases.
-
Condoms
may not always be readily available, especially in places where
contraception is against the religious traditions of the country.
It may be
difficult to get help or treatment if you get a sexually transmitted disease
or if you fear you might have been at risk.
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TRAVELLERS HEALTH – SUN AND SKIN
Although
most people enjoy going outside in the sunshine, too much sun can cause
sunburn and damage the skin leading to premature skin ageing and an
increased risk of skin cancer.
To make the most of the sun, and avoid burning, you should take the
following precautions:
-
Avoid
going out in the sun when the suns rays are at their strongest. In the UK,
this is between 12md and 2pm, but, in many holiday destinations, the times
to avoid are between 11am and 3pm.
-
Stay in
the shade whenever possible.
-
Wear
loose-fitting closely woven cotton clothes.
-
Wear a
broad-brimmed hat.
-
Do not
stay too close to water as ultra-violet rays (the ones that cause the
damage) are reflected by water.
-
Use a
sunscreen that protects against both UVA and UVB rays, and has a sun
protection factor (SPF) of at least 15. Note that the SPF numbers on
American products are double those on European products, so an American
SPF 8 is only a European SPF 4.
-
Apply
sunscreen liberally and frequently.
-
Always
re-apply sunscreen after being in water, even if it claims to be
waterproof.
-
Wear
sunglasses.
-
You
should also drink plenty of non-alcoholic fluids to prevent dehydration.
If you do
get burnt, try cooling the burnt area in tepid water for between 30 minutes
and one hour, or try applying natural yoghurt or calamine lotion to the
area.
Remember that children are at particular risk of burning and small children
should stay out of direct sunlight as much as possible. If a small child or
baby gets sunburnt you should seek medical advice.
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VARICOSE VEINS
What are
varicose veins?
Vessels that carry blood from the body parts towards the heart are called
veins. They have thin walls and, unlike arteries (which carry blood from the
heart towards the organs), they are not elastic and have no pulse. Instead
they have valves to prevent blood flowing backwards. If for some reason the
valves do not work effectively, blood stagnates in them and causes the veins
to become swollen and twisted. Although this can occur in any part of the
body, varicose veins usually develop in the legs. They may also develop in
the anal canal where they are called haemorrhoids. When there is liver
disease they may occur in the oesophagus.
Who gets varicose veins?
This is a common problem affecting between 10-20% of the population. It is
four times more common in women than men. Varicose veins develop with
increasing age and are most common in people over the age of 50 years. They
tend to run in families, although anyone who spends a lot of time standing
or who is overweight is more likely to have them. They may also develop
temporarily during pregnancy.
What can be done about them?
If your legs are constantly aching, or if the veins irritate during the day
and standing up causes discomfort, seek help from a doctor to discuss what
treatment is necessary. In all cases it is best to avoid too much standing.
You should rest your legs higher than your head for ten minutes each day
when possible, and exercise to keep the circulation going.
Lightweight, elastic support stockings or tights may help in the short term.
There are also a number of complementary medicines reputed to help
circulation, but you should only takes these on the advice of a specialist
practitioner. Aromatherapy can also be used to improve the general tone of
the veins.
If the condition becomes more serious a complete removal of the vein
(surgical ligation) can be done and this involves a few days in hospital.
There is also a new treatment available that involves injecting an irritant
into the vein, causing the opposite walls of the vein to stick together. The
effect, however, is not lasting.
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VERRUCAE
What are
verrucae?
Verrucae are also called verrucas. They are warts found on the soles of the
feet, and are also known as plantar warts. They are caused by one of the
human papillomavirus group of viruses, which is contagious and seems to
thrive in damp conditions such as swimming pools, showers and bathrooms.
Cuts or injuries to the foot increase the risk of infection. Verrucae mainly
affect young children.
What do verrucae look like?
Verrucae usually start as a tiny pink area speckled with black dots. They
then become dark brown in colour with a rough crumbly surface, sometimes
covered by a layer of hard skin. When the surface of a verruca is pared off,
several dark spots can be seen - these are the blood vessels which supply
it. Verrucae occur either as a single spot or in irregularly shaped groups.
They usually are painful when pinched rather than painful by direct
pressure.
How are verrucae treated?
Quite often a verruca will go away within a year or two, without treatment,
as the body's natural immune system rejects it. If it does not hurt and is
not getting any bigger, it is best to leave well alone. However, there are a
number of over-the counter-treatments available from a pharmacist. If the
verruca is very large or persistent it may be best to see a chiropodist or
doctor, who can then freeze or lance it under local anaesthetic.
Useful source of further information:
The Society of Chiropodists, 53, Welbeck Street, London W1M 7HE. Telephone:
0207 234 8620
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