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Contraception; your options!

studenthealth Contraception and Sexual Health, Uncategorized , , , , , , ,

Dear students, and in particular those new to the university and Bristol.

Welcome! You have picked a great city and it’s an exciting time for you all. Parties, Fresher’s week, new friends, often your first time away from home and a new course to get stuck into.

First let me introduce myself. I am Dr Tim Percival; lead GP for contraception at the Students’ Health Service (SHS). I felt it was a good time to get the message out to you all regarding your choices, what we can offer and trying to correct some of the common misconceptions regarding contraception.

We have comprehensive facilities to manage the vast majority of all contraception and sexual health issues from:-

  • Choosing the right contraception and sorting subsequent problems
  • Diagnosis and treatment of sexually transmitted infections (STI’s)
  • Taking cervical smears (if over 25 years)
  • Providing condoms and pregnancy tests free of charge
  • Generally helping you with any symptoms and problems ‘down below’.

We pride ourselves on being approachable and friendly, and we take confidentiality very seriously. So please just come and talk to us!

It is commonly thought that the contraceptive pill and condoms are the ‘usual and only’ options.Condoms are good protection from STIs and are a relatively safe method of contraception but ONLY IF USED CONSISTENTLY AND CORRECTLY.

The pill is a very good option too, especially for those that like good control of their periods. It is a misconception that the pill makes everyone put on weight and become very ‘hormonal’…this is unusual. It is also not a problem to continue the pill long term if you’re fit and healthy.

Longer Acting Reversible Contraceptives (or LARC’s) are becoming very popular for good reason. They give you the benefit of highly reliable contraception that is not prone to ‘user failure’ i.e. ‘had a few heavy nights and forgot my pill’! They are also statistically better at preventing pregnancy. The options are:-

  • Contraceptive implant called nexplanon,
  • Contraceptive injection or depo
  • Intrauterine devices i.e. the copper or hormone coils.

Let’s take each of these in turn and try and dispel some common misconceptions!

 Implant

  • Injected into inner upper arm where can’t be seen and releases hormone slowly
  • Lasts 3 years
  • Generally a simple insertion and removal with at most mild pain from small anaesthetic injection similar to vaccination
  • Very highly effective
  • Low risk hormonal side effects

 Injection/Depo

  • Injected invisibly into upper buttock and hormone released slowly
  • Lasts 3 months
  • Mild pain from injection similar to vaccination
  • Very highly effective

 Coils

  • 2 types 1) copper (IUD) and 2) Mirena (Hormone IUS).
  • Copper IUD lasts 10 years, has no hormones but can make periods slightly heavier so good for any of you with lighter periods
  • Mirena IUS lasts 5 years, has very small amounts of hormone that works locally in the womb to lighten periods so good for those with heavier periods
  • Both very highly effective
  • Can be fitted even if not had children!
  • Can be fitted at Students’ Health
  • Do not make you infertile in the long term (only when device in place!!)
  • Usually mild-moderate period like cramps during fitting. Usually not significant pain during insertion as commonly believed

 

Please remember that none of the above methods protect you against STIs so make sure you also use a condom unless:-

  • with a regular partner,
  • AND you have both had comprehensive STI screening
  • AND you are using an alternative contraceptive method e.g. pill/coil/implant etc.

 If you do have unprotected sex then please see us ASAP for emergency contraception. If we are not open chemists, A+E departments and sexual health clinics can also supply this for you. If you do get pregnant and don’t want to be please try not to panic and see us for advice on your options.

Hope this is helpful. Look forward to meeting some of you. EnjoyBristol!

Dr Tim Percival

GP Students’ Health Service

A Quick Dip

studenthealth travel, Uncategorized , , , , , ,

“Jump in”…

“Come on In” I hear them shout… The water looks cool and inviting, the surface twinkling under the sun. I’m hot and sweaty and in desperate need to feel cold water on my skin. I hear them all splashing in the water, laughing calling me in to join them… Beads of sweat have formed on my forehead, I wipe them away- my T-shirt has stuck to my back where I was carrying my daypack.

I do so want to run in, or at least take my sandals off and feel the coolness on my hot feet-  but something in my head tells me no… Why? I retrace my thoughts and vaguely remember something the nurse said in the travel clinic something about snails and freshwater…? and that Lake Malawi was high risk… ?

I can’t see anything in the water- I’m getting hotter and everyone is now in the water- calling me in to join them… What harm can it do?

 I take off my sandals and join in the fun- such a relief from the heat of the sun….

 I think nothing more of it… and 4 months later I am back in Bristol uploading my travel photos onto facebook. I find a selection of leaflets amongst my travel documents that I must have collected from the nurse in the travel clinic- one of them mentions something called ‘Schistosomiasis’ (Bilharzia).

Ahhhh this is the disease that I recalled at Lake Malawi- but I feel totally ok, not unwell at all- so I don’t think I have to worry about this. I start reading the information and it states:

‘The majority of people who contract Schistosomiasis have no symptoms’!

Oh!

But fortunately I can have a screening test 12 weeks after possible exposure which I can have done at my GP practice.

I ring up Students’ Health Service and book a nurse appointment.

Better to check after my quick dip…

 

Schistosomiasis is one of the most widespread of all parasitic infections of humans. It is the most common parasite transmitted through contact, by either swimming or wading in fresh water in parts of Africa, for example Lake Malawi. South America and the Middle and Far East are also affected.

Initial contact with cercariae can cause an itchy rash, known as “swimmers itch.” Once infection has been established, clinical manifestations/ symptoms can occur within 2-3 weeks of exposure, but many infections cause no symptoms.

 

Advice for Travellers

Avoid skin contact with fresh water in endemic areas e.g. ponds, lakes and rivers. Swim only in protected swimming pools or safe sea water. Avoid drinking infected water. Wear protective footwear when walking in soil, especially if it is damp or water logged. Those who have been knowingly exposed can be screened after return but if there are no symptoms this should be delayed for 12 weeks after the last possible exposure so as to allow the time for the development of antibodies.

 

Sources:

Students’ Health Service ‘Travel Guidelines’ patient information leaflet- available at the practice

http://www.nathnac.org/travel/factsheets/schistosomiasis.htm.

 

Taking Risks

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“I’m lying here with a drip in my arm on a hospital bed, gazing out of the window, watching a couple of local children playing with a tin can, wishing I was out there in the sun… Thank goodness I had taken out good travel insurance as I was advised; otherwise this ‘cheap’ backpacking trip would have cost me and my family a fortune in hospital costs…

Being admitted to hospital in India was not on our travel plans.

I feel so sorry for my friends who have cut their holiday short to stay and look after me and update my worried parents on my progress…

 How did I end up here you may ask? Well now, that’s a good question…

Between the many visits to the bathroom to either vomit or have profuse diarrhoea- been probed, prodded or injected with goodness knows what-  I have been lying here asking myself that very question over the last few hours…

 I remember what the nurse told me in the travel clinic about water and food precautions- but how many times did I take risks??

 Was it those delicious tomatoes that I bought from a street seller but which I didn’t bother to wash… that local ice cream that was sooo refreshing… those prawns that looked so fresh… that salad… that meat that was not cooked quite so thoroughly… the buffet we treated ourselves to- how long had it been kept warm for… those ice cubes in my drink… or indeed running out of bottled water and brushing my teeth with tap water?

I have also been eating with my hands a lot and not washed them as much as I should have, and it didn’t help that I’d forgotten to pack some alcohol gel…

I wish I’d been more vigilant with precautions as I was advised,and not taken any risks…”

 

Any one of these risks could result in severe travellers diarrhoea due to transmission of a bacteria/parasites/virus/cysts.

For advice on prevention please read from the list of sources below.

 

Remember that Traveller’s Diarrhoea is the most common illness you will be exposed to and the main danger is dehydration, which, if very severe, can be fatal if untreated.

Treatment is therefore rehydration– ensuring you drink plenty of clean water, particularly salty soups and fruit juices with bland bulky foods- bread, pasta, rice and potatoes. You will also need to replace some of the lost salts by taking an oral rehydration sachet e.g. Dioralyte. Anti diarrhoea tablets should be used sparingly and only when truly necessary e.g. a long distance bus/train journey.

Contact medical help if the person has:

♦ A temperature

♦ Vomiting and unable to keep fluids down

♦ Blood or mucus in the diarrhoea

♦Persistent diarrhoea

♦ Become confused

♦Any pre existing medical conditions e.g. diabetes

 

Sources:

Students’ Health Service ‘Travel Guidelines’ patient information leaflet- available at the practice

http://www.nathnac.org/travel/misc/travellers_food.htm.

http://www.fitfortravel.nhs.uk/home.aspx.

It only takes ONE bite!

studenthealth travel, Uncategorized , , , , , , , , ,

“Off to Tanzania- leave in a couple of days! Sooo excited- mustn’t forget my yellow fever certificate- what was it the nurse said- Oh yes to photocopy it, keep this separate and put the original in my passport- good advice. I’ve been planning this trip for months- teaching English to children and construction work in a remote village. Not sure what to expect as staying with a local family- what will their home be like? What will I eat? How hard will the work be? Will they have internet close by??

Must start taking my malaria tablets… and remember to take them everyday.

 What an amazing country- full of colours, sights and smells… Love it! My host family are so welcoming and generous, I’ve settled in well- if a little homesick to start with- and enjoying the teaching. The children are sooo adorable. I have made a couple of friends here who are also doing charity work- one in particular Sarah who is staying with the same family as me.

We are sharing the same room which is rather basic but home to us now and it’s good to have the company- Luckily my little travel sewing kit came in useful as managed to tear a hole in my mosquito net on the first night!

Its such a different world here- so lovely eating dinner every evening outside under the stars- Although there are lots of mosquitoes so have been spraying myself with DEET and wearing my long shirt and trousers as the nurse in the travel clinic advised- mentioned this to Sarah, but she doesn’t seem that bothered with this- wearing vest tops and shorts- as says ‘she doesn’t usually get bitten’ and is taking her antimalarial tablets like me everyday anyway.

 We have now moved on to helping build another room for the school. Sarah hasn’t been well since waking up this morning- feeling a bit ‘fluey’ muscle aches and a headache- she reckons its too much sun as we spend a lot of our time outside now, she’s going home to bed- I’ll check on her at lunchtime…

 Sarah isn’t at all well – she now has a very high fever I’m really worried about her… I spoke to one of the charity organisers and they have sent her straight to hospital with suspected malaria. I cannot believe it! She only has a few mosquito bites- I know she didn’t cover up or use insect repellents, but she took her antimalarial tablets just as I did everyday.”

 

 

♦ Between 1990 – 2009, every year approximately 1,800 British travellers returned home with malaria.

♦ The UK is one of the biggest importers of malaria in Europe.

♦ The most severe form of malaria (plasmodium falciparum) accounted for 79% of cases amongst British travellers in 2009.

♦ Malaria is a preventable infection but can be fatal if left untreated – an average of nine people die each year from malaria in the UK.

♦ Malaria is transmitted by an infected mosquito. It only takes one bite from an infected mosquito to contract malaria.

 

Remember that antimalarial tablets reduce your risk of malaria significantly, but they are not 100% effective.

ABCD of malaria prevention:

Be Aware of the risk

Bite prevention

Compliance with Chemoprophylaxis

Recognising symptoms and prompt Diagnosis

 

Sources:

Students’ Health Service ‘Malaria Advice’ patient information leaflet- available at the practice

https://www.malariahotspots.co.uk/index.html.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

A Very Peculiar Practice… or is it?

studenthealth General, Uncategorized , ,

http://www.bbc.co.uk/cult/classic/verypeculiar/videoclips/video0.shtml

I prefer to think of it as a unique and special GP Practice; after all I have worked at Students’ Health for 25 years!!

Nursing and GP colleagues in other practices have been heard to say at every possible opportunity……. “That must be a doddle, looking after students. They are all so healthy! Nice little job with long holidays!”

I say “come and work a day with us and you will be amazed at what we do!”

We experience the rich diversity of students and their lives, and love interacting with them.

 Our working days are unpredictable; from critical to chronic medical situations, chaotic to highly organised patients, all needing an individual response to meet their needs at that point in their lives!

Young people are the future and deserve the best care that we can offer them. 

Health education as in educating how to look after themselves and make good lifestyle choices not just a “sticking plaster service”.

Enabling our patients to be well informed, learn about and find the right contraceptive method.

The University of Bristol Students’ Health Service is a leading edge primary care practice with highly qualified and experienced staff.

The nurses may not deal with many pressure sores or leg ulcers but when it comes to knowing about contraception and sexual health we certainly know our condoms!

Nursing Team

Consists of 9 nurses including 2 Healthcare Assistants and all have their specialist areas such as:

Smoking cessation

Asthma / allergy

Nurse prescribers

Travel

Sexual Health and contraception

Mental health

Eating Disorders

Deliberate Self Harm

 

What can we offer you?

Great, modern facilities

Warm and reassuring welcome

A genuinely patient centred approach based on your individual needs

We really listen and won’t judge you, whatever you come with we have probably seen it before!

Practical support

Advice

Experience

 

 What can you do to help us help you?

  • Register with Students’ Health Service when you arrive in Bristol, don’t leave it until you are feeling ill or in crisis
  • Keep your appointments and arrive on time

      We have  a wide variety of appointment times available – early morning, lunchtime, evening and Saturday morning

  • Come and see us before a crisis develops
  • Understand that we will always strive for excellent clinical care, even in difficult circumstances
  • Be aware of other students’ needs, these may have to take priority if someone is seriously ill
  • Look out for each other, especially if your friends are ill
  • Our service is confidential so be honest with us

And most importantly of all have a wonderful time at Bristol University, stay safe and healthy

But if you need to……… Come and see us that is what we are here for!

 

How to beat exam stress

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Things the prospectus doesn’t tell you #17: Revision and exams

John Wilford, Sport Exercise & Health

 

Arrrggghhh.  Are your days broken down into 30-minute, colour-coded blocks of revision? Getting up early to claim a library desk? Staring at notes and screens until your eyes throb?  Before you know it the day ends, you’re hungry, dehydrated and your head hurts.  Welcome to the Summer term! 

 Stop. Breathe. Relax. You’re a finely-tuned, exam-passing machine. An athlete of academia. For any athlete, quality of training is more important than quantity; rest, recovery and refuelling must be programmed into their day. 

 Now look at that revision planner.  Which coloured blocks are for eating, sleeping, relaxing and exercising?  Don’t run on empty. You need to be relaxing, refuelling and refreshing yourself to survive and do well. 

 

Relaxing

  • Relaxation techniques: Practise tensing and relaxing each muscle group in turn starting with your toes and working your way up the body.
  • Breathing: Practise breathing deeply, evenly and slowly.
  • Sleep: If tired it’s hard to concentrate and maintain perspective. If you’re finding it difficult to drop off, cut down on stimulants (e.g. caffeine and alcohol) and allow time to unwind before bed. The key to feeling refreshed is having a regular pattern. Getting regular exercise helps (but not immediately before bed).
  • Massage and exercise (pilates, yoga, tai chi separately or combined in ‘Body Balance’ classes) are available from Sport, Exercise & Health
  • Therapeutic relaxation groups are organised by Student Counselling

 

Refuelling

What we eat and drink influences not only physical performance but mental performance too. If you want to boost concentration, memory and mood in the run up to exams try some of these:

  • “5 a day” of fruit and veg
  • Oily fish every week
  • Cut down “bad“ fats. Don’t rely on fast food!
  • Good breakfast to start the day
  • Eat regularly and have healthy snacks (raw carrots, celery, chopped nuts, raisins, dates, etc.)
  • Drink plenty of fluids (recent research suggests drinking water during exams can help improve grades – so don’t forget your water bottle!) though limit caffeinated and sugary drinks, especially before bed
  • Go steady with alcohol – bad for performance and sleep quality

 

Refreshing

Some anxiety can help motivate, but high levels of stress cause excess adrenaline resulting in headaches, racing heart, fatigue, irritability and sleep problems.  Physical activity uses this adrenaline, reducing these symptoms. It also releases endorphins, improving your mood.  Including some exercise in your day will boost energy and clear your head. It doesn’t have to be a two-hour gym session or a five-mile run. A brisk walk is great exercise and doesn’t need specialist kit or planning.  Even small bouts of activity can reduce tension and boost productivity.

 An organised class or activity could help.  Schedule them to fit your timetable.  It will give a welcome break from academic thoughts – and you’ll mix with different people.

 University gym staff note that many regular exercisers stop during this time of year.  Apart from one notable group – medical students.  What do they know that others don’t…..?

 

So, Wilf’s theory of revision optimisation (with apologies to mathematicians everywhere)…

 

Relaxing x Refuelling x Refreshing = Revising3

 

 

Further information: