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PATIENT INFORMATION TOPICS

ABNORMAL BLEEDING

Always see your doctor if you pass blood in the Faeces, Urine , or you cough or vomit it up. Nose bleeds and bruising on the backs of the hands in the elderly , are less cause for concern.

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BACK INFORMATION

Back pain is usually not due to serious disease ;  most back pain settles quickly, at least enough to get on with your normal life.  Backache can be very painful and you may need to reduce activities for a time. But rest for more than a day or two usually does not help and may do more harm than good so keep moving!  Your back is designed to move and work.

The people who cope best with backache are those that stay active and get on with their life despite the pain. Worrying about the pain leads to muscle tension making the pain worse.

The faster you get moving the sooner your back will feel better. Stay at work if possible but avoid excessive lifting bending and driving..

Activity promotes healing so take regular exercise such as walking,swimming or cycling.

CAUSES. Most backaches are simple muscle and ligamental pains from the soft tissues of the back.  Sciatica is the result of a disc protrusion pressing on the lumbar nerves resulting in referred pain or numbness in the calf or foot. These two comprise the majority of back pains. Investigations are often not required unless the pain persists for more than 2/3 weeks. Routine XR in the absence of significant indication do more harm than good

SELF MANAGEMENT OF ACUTE BACK PAIN.

** Rest for one to two days, if severe lye flat either on a firm mattress or on the floor.

** Avoid sitting. this increases the pressure in the discs.

** Avoid lifting bending or driving.

** Take pain- killers either paracetamol based tablets or anti-inflammatories. Ibuprofen 4OOmg 3 times a day, purchasable over the counter]

** Ice packs are helpful, 15 minutes intervals to the painful area.

** Shower rather than bath.

** Lumbar lordosis stretching exercises see below.

PREVENTION

1. CORRECT POSTURE IS ESSENTIAL maintain the lumbar lordosis during standing, lying, sitting and driving. This reduces the backward strain on the disc preventing slipping [prolapsing ]and keeps the spine in a neutral non-straining position.

2. Avoid Obesity

3. Lift Wisely bend the knees not your back

4 Strengthen your back with regular exercises cycling, swimming, and walking.

5. Avoid smoking. Smoking is strongly related to backache by impairing collagen renewal and decreasing the blood supply to the back.

WHEN TO SEE YOUR DOCTOR

Persistent sciatica

Feeling unwell with the back pain. and pain at night.

Difficulty passing urine or numbness around your genitals or anus.

Numbness, pins and needles in both legs.                                                                                      Top of Page

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BURNS AND SCALDS

Apply large quantities of cold water to the affected area immediately and continue until the pain eases and the skin cools. Any blisters that are present should not be burst and may be covered by a loose, dry dressing.

Take simple analgesia for the pain. If the skin is broken or a large area is affected, consult your doctor.

Infection can be a problem - seek advice if you are unsure.

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CHICKENPOX

Is caused by a virus. Over a few days a rash develops with tiny blisters scattered all over the skin. The spots, which are very itchy turn 'crusty'. Some people find Oily Calamine lotion soothing. Dressing in light clothing and taking cool baths may help.

Children may return to school after the last 'crusts' have dropped off.

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COLDS AND FLU

Colds and flu (influenza) are often confused. Their symptoms are similar but colds are more common and usually less serious. Flu also tends to last longer, and can leave you feeling under the weather for two or more weeks. Antibiotics have no effect on uncomplicated colds or flu, but simple home treatments can help you feel better.

Signs and symptoms

· Colds: Mild fever, runny nose and sneezing, watery eyes, cough and sore throat.

· Flu: Fever, chills and high temperature, headache, muscle and bone aches, and dry cough. Runny nose and sneezing may also occur.

· Chesty cough and earache can occur, if there is a chest or ear infection.

Causes and complications

Colds and flu are caused by viruses. There are many different types of these viruses which is why you can catch them more than once. They are passed between people in mucus droplets from sneezing or coughing, or by physical contact (e.g. unwashed hands).

Colds are seldom serious but can cause problems in babies, the very old, and those with serious illness. Bacterial infections of the ears  and chest can be a problem in both conditions, but especially with flu.

Prevention

It's difficult to prevent yourself catching colds and flu, but you can cut down your chances by keeping away from infected people. If you fall into the list of those who are in danger of getting seriously ill from flu, ask your doctor about a flu vaccination (see 'When a flu vaccination is needed', ). A balanced diet and regular activity will help boost your immune system and your resistance to colds and flu.

HOME TREATMENT

There is no cure for colds and flu. Antibiotics are of no use, unless you get a chest or ear infection as well. Following a few simple steps will help you feel better and get well faster:

· Rest - don't exercise

· Drink plenty of non-alcoholic fluids. Fluids are especially important for children to replace water they lose through sweating

· Take paracetamol adults , 2 tablets 4 times a day, ibuprofen or soluble aspirin, but follow the instructions on the label. Children under 12 years can be given a sugar free paracetamol syrup

· Stop smoking

· Keep your bedroom warm but airy - don't wrap children up too warmly

· Sponge children with lukewarm water if their temperature is high

· Stay at home for a couple of days after the symptoms are gone.

Consult your doctor if:

· The fever is still there after 4 days

· Fluid intake has declined or stopped

· A child acts oddly, e.g. change in speaking or walking, unable to sit up, drowsy all the time

· There is any wheezing with breathing

· There is very bad earache

· There are signs of meningitis [ neck stiffness ]

· There is chest pain or shortness of breath.                                                                                  

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CONSTIPATION

This is a common problem as we get older, since we do not eat so much, nor do we take as much exercise. Often drugs prescribed by the doctor (eg water tablets ; pain-killers) lead to constipation. It doesn't matter if you don't go to the toilet every day or even only once or twice a week. It is more important that the motions are not too hard. By drinking plenty of fluids and eating fibre, eg brown bread, bran, vegetables and fruit, most people can control symptoms. Do not take stimulant laxatives such as Senna on a regular basis.

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CYSTITIS

Is due to an inflammation of the bladder which causes pain on passing water and a feeling that you need to go again straight away. Drinking plenty of fluids can help. Simple preparations from the chemist can help make the urine less acid and ease the burning pains. Take Paracetamol or Aspirin for pain and rest.

Persisting cystitis , with severe symptoms , and always that accompanied by , back/kidney pains require antibiotics. Attend your Doctor with urine sample, or if recurrent this may on occasions be treated over the phone.

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DIARRHOEA AND/OR VOMITING

Stop eating solid food and take clear liquids only. In adults with diarrhoea and vomiting a virus infection is often responsible and is therefore unable to be treated directly - symptomatic treatment from the chemist can be helpful. Consult your doctor if the symptoms persist for more than a few days.

STOOL Samples are required    If Diarrhoea persists over 5 days, is accompanied by blood or fever, in suspected food poisoning outbreaks and after foreign travel.

Diarrhoea in very young children and babies needs careful attention. Many babies have looser bowel action during their first six months due to their predominantly liquid diet. Oral rehydration fluids are available from the local pharmacy. If the symptoms persist for more than 24 hours, the child seems very unwell, or there is accompanying vomiting or weakness, consult your doctor. A little child who appears severely ill warrants bringing to the attention of the doctor urgently.

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EARACHE BUDS   Please, don't use these to remove wax, they don't work and frequently result in perforated ear drums and infections. Please attend the nurse instead if you feel your ears are full of wax, for them to be syringed.

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HEAD LICE   Pediculosis Capitis, are very common in children and bear no realtion to personal hygiene. In the past all family members were regularly treated with lotion at the mearest hint of head lice and although topical insecticides are probably safe  in their limited use, but they should only be used only where there are definite live lice seen and not just egg cases. Ideally this should be repeated in 2 days after the emergence of the new lice from the eggs.

Prevention is important with regularly wet combing following conditioner . Tea tree oil may also be effective

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SORE THROATS AND TONSILLITIS

Sore throats are common and seldom serious. Most sore throats will settle within a few days without needing any medication. Laryngitis, which is an infection of the voice box, can also cause a sore throat.

Tonsillitis simply means the tonsils are inflamed, and it is not usually serious. It's more common in children, who can get repeated attacks. Tonsils are an important part of the body's defence system, so they are rarely taken out nowadays. The discomfort of sore throats and tonsillitis can be helped by simple home remedies.

Signs and symptoms

· Throat and/or ear pain.

· Hoarseness or loss of voice.

· Swollen glands on either side of the neck or jaw.

· Difficulty with swallowing.

Causes and complications

Most sore throats are caused by viral infections. Tonsillitis can be due to infection by a virus or bacteria. The most common problem is repeated tonsil infections, leading to a lot of time off school for children, and poor eating habits. Occasionally, tonsillitis can cause abscesses on the tonsils and the area around them (see 'Consult your doctor if', below).

It is difficult to keep away from the germs that cause sore throats and tonsillitis.  However, the discomfort can be soothed in the following ways:

· Gargle with soluble aspirin dissolved in a glass of water, and then swallow (not in children under 12 years). Drink liquids like honey (1 teaspoon) and lemon (teaspoon) in warm water

· Don't drink acid drinks or eat spicy food

· Suck sugar free lozenges (read the label)

· Take simple painkillers (e.g. a sugar free liquid paracetamol preparation for children), especially at bed time.

· If you lose your voice from laryngitis, follow the tips above and try not to talk. Also, don't smoke or drink alcohol.

Consult your doctor if:

· Swallowing drinks is impossible

· A child is drooling and seems unable to swallow their saliva

· There are signs of meningitis

· There is difficulty breathing

· There is a constant temperature over 390C/102F

· There are repeated tonsil infections or abscesses.                                                                      

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SKIN PROBLEMS     http://www.swis.net/excg/derm/dermind.htm

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TIREDNESS AND ANAEMIA

Everyone feels tired sometimes, usually because of too little sleep, but constant tiredness should be taken seriously. Anaemia, which is often due to a lack of iron, can cause tiredness as well as other symptoms, especially in women. Fortunately, it can be recognised and treated quite easily.

Signs and symptoms of anaemia

· Skin, lips, tongue, nailbeds or the inside of eyelids are pale in colour.

· Feeling of weakness.

· Dizziness or fainting spells.

· Breathlessness, especially after exercise.

· Fast heartbeat felt in the neck or chest (palpitations).

Causes and complications

The usual cause of anaemia is lack of iron in the diet and sometimes lack of vitamin B12. It can also occur after blood loss (e.g.nose bleeds, heavy periods ).

Dealing with other causes of tiredness

· Disturbed sleep: Try getting one or two uninterrupted nights and see if you feel better .

· Depression and stress: The tiredness associated with these conditions should improve if the underlying problem is treated appropriately

· Excess alcohol intake: Even if you drink only moderately, try cutting out all alcohol for a week or so.

· Recent infectious illness: Don't expect too much of yourself after an illness like flu. Eat a nourishing diet and take things easy for a couple of weeks.

Consult your doctor if:

· The problem continues after you have tried the actions listed above

· You are constantly tired for no apparent reason - especially if it's affecting your work or relationships

· You have difficulty sleeping because of night-time trips to the toilet

· Your stools are black and tar-like.    

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