More to Pharmacies than meets the eye

studenthealth minor illness, Uncategorized , ,

Did you know that perhaps one in seven GP appointments could be dealt with by pharmacies? This equates to 40million appointments per year. You may think of your local pharmacy as just a place to pick up your prescriptions or toiletries – but there is more to a pharmacy than meets the eye.

A recent article in the BBC health news

http://www.bbc.co.uk/news/health-25744060. highlighting the services pharmacies now provide, struck a chord with me. Having qualified as an independent nurse prescriber in 2011, many of the consultations I now deal with involve minor illness – i.e. sore throats, coughs, colds, sinusitis etc… Interestingly numerous student patients who present have not self treated by taking any over the counter medicines to help ease their symptoms. For those that are unsure about what to take, many have not consulted with a pharmacist for advice. In reality, after careful assessment, the majority of minor illness we see in general practice tends to be of viral origin – so antibiotics are not indicated – advice is then to take regular ‘over the counter’ medications i.e. paracetamol, ibuprofen (if safe to take) rest and fluids. These medications can be bought very cheaply from your local pharmacy.

A pharmacist can deal with and advise on cold and flu symptoms.

The Pharmacy Voice chief exec states that ‘Pharmacy is the third largest health profession (in the health sector) after medicine and nursing, yet people still don’t really know who we are and what we do’.

Pharmacists have been given increasing responsibility within the NHS, and many professionals, like myself, can also now prescribe ‘prescription only medicines’; medicines that only a Doctor might previously have prescribed for you. They are also able to sell Pharmacy ‘P’ medications i.e. antibiotics eye drops for eye infections, emergency contraception, vaginal thrush treatment; and provide stop smoking advice, pregnancy testing and sexual health screening.

 

‘Community pharmacies are perfectly capable of taking the strain from GP and A+E departments that are bursting at the seams.’ One out of every four people who go to A&E could have been treated elsewhere in the community, or could have self-treated. Your local pharmacy can help treat common illnesses.

Please pick up this leaflet from SHS or download from the following: http://www.bristolccg.nhs.uk/media/25934/feelingunwell_choosewell.pdf.

 

Self-injury awareness day

studenthealth Mental Health, Uncategorized , , , , ,

March 1st marks ‘self-injury awareness day’, a global movement signified by the wearing of an orange ribbon, which aims to increase the awareness of self-injury and challenge many of the misconceptions surrounding this.

What is self-injury? Self-injury, also known as ‘self-harm’ or ‘cutting’, describes how someone intentionally inflicts physical injury to their own body without any suicidal intent. It can take on any form, whether it is cutting, head banging, hair pulling, burning, recreational drug or alcohol abuse, non-lethal drug overdoses or taking excessive risks to personal safety.  It affects people regardless of age, gender or ethnicity, although it is known to be particularly common in younger people.  Due to the shame and self-hatred often associated with self-harm, many sufferers will go to great lengths to hide scars, making it difficult to identify those needing help, and also to estimate how prevalent this is.  Research suggests that at least ten percent of 15-16 year olds have self-harmed at some point in their lives.

Why do people self-injure? Self-injury is recognised as a coping mechanism for overwhelming emotional distress relating to current traumas or difficulties from the past.  The distress might be grief, anger, loneliness, emptiness, anxiety or self-hatred and sufferers may describe how the ‘real pain’ of self-harm numbs their emotional turmoil, and in some cases acts as a way of avoiding attempting suicide. Over time self-injury might become a person’s ordinary response to everyday stressors, sometimes increasing the frequency and severity of injury.

What to do if you are self-harming? GPs are well placed to provide confidential advice and support, put you in touch with local and national self- injury organisations (see below) and check for any underlying depression/ anxiety or eating disorder symptoms. The Student Counselling Service is also somewhere safe and non judgmental to go to.

Is there treatment for self-harm?  Yes there can be, and the aim of treatment may be to both minimise harm from acts of self-injury and to help the sufferer find new coping mechanisms and develop problem-solving skills.  Strategies to minimise harm include recognising triggers for self-injury, learning less dangerous ways/locations for cutting, carrying dressings and understanding the dangers associated with certain medications. However, stopping the self harm is not necessarily the aim of treatment, which may be more directed towards underlying issues.

Talking therapy (e.g. cognitive behavioural therapy/ dialectical behavioural therapy), creative therapy, support networks and the promotion of the development of self-help skills all help in supporting a sufferer to learn new coping mechanisms.  If self-harm is part of an underlying mental health illness, specific treatment for that condition may be warranted.

I am worried that my friend is self-harming?  It is upsetting to discover a friend is self-harming but it is important to provide non-judgmental support and acceptance, acknowledging that they are distressed. Encouraging them to talk to health care professionals or contact a local support group will show them that you care. Asking a person to stop self-harming will not help the situation as you are asking them to take away their coping strategy.

Will I/my friend get better?  There are no quick fixes for self-harm, but by getting a person the right support and treatment, they will start to learn new ways to deal with their emotional distress.

References/ literature available:

 

  1. Life Signs Self-Injury Fact Sheet for Health Care Workers- www.lifesigns.org.uk
  2. Information resource pack- Bristol Crisis Service for Women –www.selfinjurysupport.org.uk
  3. NHS self injury fact sheet- http://www.nhs.uk/conditions/self-injury/pages/introduction.aspx
  4. MIND- ‘understanding self-harm’- http://www.mind.org.uk

 

Support Groups

Self Injury Self Help- support groups for women and men who self-injure in the Bristol area. www.sishbristol.org.uk

TESS- Bristol Crisis Support for Women, text or email support service for girls and women who self-injure- up to age 25.  www.selfinjurysupport.org.uk, or text 07800472908

MIND- for information sheets/ advice about local resources- www.mind.org.uk

 

 

Eating Disorders Awareness Week; 24 February 2014.

studenthealth Eating Disorders, Mental Health, Uncategorized

Beat, the Eating Disorders Charity, is running a national awareness week called ‘Sock it to Eating Disorders’ this week. It is a light hearted way to bring people together, do a bit of fundraising, and raise the profile of a devastating group of conditions.

As a GP at Students’ Health I deal with such conditions most weeks, and one can become too focussed on the medical aspects, so it’s good to stop and think occasionally about what these illnesses mean to the people who suffer from them, and their friends and families. And nothing brings that home like the Beat “Lasting Memories” page, which reminded me of the immense impact that such a potentially fatal condition can have.

What a long list of lost young people, mainly women, and so many aged around 18-20, like the students I look after every day. The messages left by family and friends are heart breaking, and this online wall of memorials is a sobering reminder of why I and my colleagues spend so much time and energy improving and developing local services for Eating Disorders in Bristol.

We have made it so much easier in the last 2 or 3 years to get help that hopefully such memorials will become rare, and fewer families will be turned upside down by such tragic deaths.

Here at Students’ Health Service we really do want to help you if you have, or think you might have, an eating disorder, so please do come and see any of the GPs, and talk about referral onto First Step, the new Bristol-wide community based service for assessment and therapy. First Step is led by a clinical psychologist, and you can have your appointment in the same building as the GP practice, no need to go to hospital. The average waiting time for an appointment with them is about 3 weeks, not long at all, so don’t hesitate if you are suffering… come and talk to us.

 

http://www.b-eat.co.uk/support-us/get-involved/lasting-memories/

 

http://www.awp.nhs.uk/news-publications/trust-news/2013/july/another-step-forward-in-eating-disorders-support-for-bristol/

Think about sex day; Valentine’s Day 2014!

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

Are you thinking about sex? Maybe. Studies tell us that on average you will do 19 times a day if you’re a man, and 10 times a day if you’re a woman!

It’s normal!

What sort of thoughts? The more graphic thoughts I will leave to your imagination but there are numerous reasons why people will think about sex.

Let’s think of some of the less positive thoughts that may cause distress:-

– Sex is always painful

– I’m not getting enough sex

– I love sex but I’m not sure I’m any good

– Have a caught an STI (sexually transmitted infection)? HIV? Other?

– Sex brings back awful memories for me

– Where shall I get condoms/emergency contraception/sexual health checks from?

– Am I big enough?

– Do my genitals look odd? Am I normal? Is that a wart?

– Fears of pregnancy?

– I’m embarrassed to get help or ask advice

 

Please don’t sit alone worrying about these things. Often the worry is needless and reassurance is all that is required, but if not, help is out there.

If you’re not sure about what to do about your worry then preferably ask a health professional e.g. GP/practice nurse/local sexual health clinic. Book an appointment with us. Another alternative is to do your own research in books or on the internet but please take care that you use reputable sites.

Sex is normal. Thinking about sex is normal. Do it as often as you like. If you have sex make sure you do it safely.

The most important part is to not be shy or embarrassed but to come and ask. Remember we nearly all do it, think about it and worry about it at some time. If we didn’t then none of us would be here of course!

See below for some great helpful websites and resources

 

http://www.national-awareness-days.com/think-about-sex-day.html

 

Sexual health – Live Well – NHS Choices

FPA – the sexual health charity | FPA

http://www.brook.co.uk

Symptom Checker, Health Information and Medicines Guide | Patient.co.uk | Patient.co.uk

Find Sexual health information and support services – NHS Choices

 

Have a good day!

Love Hearts …or Love Hurts?

studenthealth Uncategorized

Roses are red and violets are blue,

No one in the bar was as gorgeous as you.

I brought you home; I was over the moon,

In the morning I was singing a different tune…

 

Alcohol can contribute to risk-taking behaviour that can lead to unwanted pregnancies and sexually transmitted infections

A survey of 16 – 24-year-olds found that after drinking alcohol-

•             One in seven have had unsafe sex (i.e. not using a condom)

•             One in five had sex and later wished they hadn’t

•             One in 10 were unable to remember whether they had sex the night before

•             Many (40%) agreed that they would be more likely to have casual sex

 

Saint Valentine’s Day has long been associated with love, romance and gifts.

 

Will you receive a gift from your loved one……or is the relationship ‘complicated’?

And what if the gift you are given is an unwanted one that can cause ‘complications’…such as Chlamydia?

Most people with Chlamydia have no symptoms. It‘s the commonest Sexually Transmited Infection (STI) in the under 25’s with 1 in 20 people affected.

We are encouraging everyone under the age of 25 to take a combined Chlamydia and Gonorrhoea test if they have ever been sexually active.

This test should be repeated yearly and with any change in sexual partner. It’s a simple self-taken test on either a vaginal swab or urine specimen. The result can even be sent by text or email. Pop into the surgery to pick up a test kit from the office, or book in for a test.

 

You may also want to consider screening for blood borne infections (BBV) such as HIV, Hepatitis or Syphilis if you have had higher risk sexual partners.

This would include anyone who has injected drugs, paid for sex, men who have sex with men and their partners, and any partners from regions with a higher incidence of HIV (above 1%) such Sub-Saharan Africa.

You can call the office (0117 3302720 Option 2) and leave your details to arrange an asymptomatic sexual health appointment for BBV testing, and or book in for a Chlamydia and Gonorrhoea test.

So, wishing you a Happy and Healthy Valentine’s Day with no unwelcome gifts….

 

 

It’s Time to Talk about Mental Health! #TimetoTalk

studenthealth General, Mental Health, Uncategorized, Wellbeing ,

This weeks blog is a quiz!

Time to stop the stigma surrounding mental ill health. See how much you know in the attached short quiz, via the link below. Scroll to the bottom of the linked page to see the Myth/ Fact quiz.

Then spread the word. It’s OK to talk about mental health!

http://www.time-to-change.org.uk/downloads

http://www.time-to-change.org.uk/

 

 

 

 

Figs, Chestnuts , Nutmegs, Baubles and Jingle berries!

studenthealth Uncategorized

Actually I am not talking about Christmas items, but some of the names given to testicles!

The Male Cancer website ‘Your Privates’, run by the charity Orchid, gives 33 different names to testicles- I challenge you to see if you can think of them all! (Some of the least rude answers are at the end!).

The website does, however, also have an important message to convey to all you men out there:

‘Get to know your Balls’………or whatever name you like to use for them.

Testicular cancer is the most common cancer in men aged between 15-45 years with just over approximately 2200 new cases a year. However, if found at an early stage cure rates of 98% are usually possible. Even when testicular cancer has spread to other areas of the body cure can still be achieved. Recent research has suggested that 96% of all men with testicular cancer should be cured.

So to assist early detection you need to be performing Testicular Self Examination, in other words getting to know what’s normal for you!

Testicular Self Examination

Perform Testicular Self Examination (TSE) about once a month.

The best time is after a warm bath or shower (so the scrotum is soft and relaxed)

Get to know your balls and if you find something abnormal, get it checked out. This may include a lump or a noticeable increase in size or weight of the testicle.

The website (link below) contains a video demonstrating TSE (under testicular health and awareness)

What to watch out for?

A lump can be felt in 97% of cases of testicular cancer, and in approximately 86% of cases this will be painless. However, also remember that only 4 in 100 lumps will be cancer. There are many other causes of lumps or swellings in the scrotum including infection (Epididymo-orchitis), fluid (Hydrocoele), varicose veins ( Varicocoele), and Epididymal cysts. Many of these can be easily diagnosed when examined by a doctor, but a simple painless Ultrasound Scan may sometimes also be required.

So grab those ‘crackers’ and add ‘Getting to know you Baubles’ to your New Years Resolution list alongside your regular Chlamydia test!

http://www.yourprivates.org.uk

Answers- acorns, baby-makers, back wheels, baubles, chestnuts, cods, conkers, cream crackers, doodads, figs, globes, goolies, hairy conkers, heirlooms, jingle berries, knackers, love apples, love nuts, love spuds, marble halls, meaty bites, nads, nobby halls, nuggets, nutmegs, nuts, plums, rocks.

Cervical screening…what does that mean?

studenthealth Contraception and Sexual Health , , ,

Cervical Cancer Prevention Week 19th – 26th January 2014

Cervical cancer is the 11th most common cancer among women in the UK, and the most common cancer in women under 35, though still uncommon in real numbers. Did you know that the main cause of cervical cancer is the Human Papilloma Virus (HPV)?

HPV can cause abnormal changes to the cells on the cervix (neck of the womb). The HPV virus is a very common infection and most people who are sexually active will get it at some point. Unfortunately, you wouldn’t know that you have HPV as the virus shows no symptoms. Fortunately, the virus usually clears spontaneously, and any changes to the cervical cells usually resolve on their own. However, for some of us, that doesn’t happen. Cervical screening detects these microscopic changes.

If you are a female aged 25 or above you will receive a letter inviting you to make an appointment for cervical screening. It used to be called a ‘smear test’ or ‘pap smear’. When you receive the letter you need to book an appointment at your local GP practice. At Students’ Health Service this procedure is carried out by one of the nursing team in a 15 minute appointment.

It’s important that you tell your GP practice about any change of address so that we’re sure that you’ll receive a letter.  The best time to make an appointment for is around the middle days of your cycle, when you are not bleeding.

The aim of cervical screening is to detect and treat pre-invasive disease of the cervix which could potentially otherwise lead to cancer.

Cervical screening prevents nearly 4000 cases of cancer per year and saves around 5000 lives.

Cervical cancer is more common if you smoke (women who smoke are about twice as likely to develop cervical cancer as non-smokers), take immunosuppressant drugs, started having sex at an early age or have had several sexual partners, or have had a sexual partner who has had several other partners (however, a woman with only one partner could contract HPV if that partner has previously been in contact with the virus). It’s also important to inform a health professional of any unusual symptoms, such as bleeding between periods or after sex.

Cervical screening is one of the best defences against cervical cancer, along with not smoking, and using condoms regularly.

 HPV vaccination

HPV vaccination also helps to prevent cervical cancer by protecting against the most common HPV viruses. The current vaccine protects against 4 of the HPV types, thus preventing approximately 70% of cervical cancers. There are many HPV types, so even if you have had a complete course of HPV vaccinations it’s important to have regular cervical screening to detect any changes caused by the viruses not included in the vaccination programme.

Further information regarding screening can be found at

http://www.cancerscreening.nhs.uk/cervical/screening.html

 

http://www.jostrust.org.uk/about-us/who-are-we

 

Is the Hippocratic Oath still relevant today?

studenthealth General, Uncategorized

There was a time when doctors swore an oath when they qualified, and in some medical schools they still do. We didn’t but I was curious to read the Hippocratic Oath, and to see if we missed out, and whether it still felt relevant in modern medicine. After all, 400BC is a long time ago!

 

There have been a couple of modern revisions, in 1964 at Tufts Medical School, Boston, Massachusetts, the Dean of Medicine wrote a ‘modern version’, and the BMJ published a more recent revision a few years ago. It begins;

“The practice of medicine is a privilege which carries important responsibilities. All doctors should observe the core values of the profession which centre on the duty to help sick people and to avoid harm. I promise that my medical knowledge will be used to benefit people’s health. They are my first concern. I will listen to them and provide the best care I can. I will be honest, respectful and compassionate towards patients. In emergencies, I will do my best to help anyone in medical need.”

It goes on to cover respect, especially of vulnerable people; remaining independent of politics; not putting profit before patients; respect for life, but not at any cost; a holistic approach; informing patients of their options; confidentiality; knowing the limits of one’s own knowledge; respect for colleagues, and finishes;

“I will use my training and professional standing to improve the community in which I work. I will treat patients equitably and support a fair and humane distribution of health resources. I will try to influence positively authorities whose policies harm public health. I will oppose policies which breach internationally accepted standards of human rights. I will strive to change laws which are contrary to patients’ interests or to my professional ethics.”

There is no doubt in my mind that the original and modern versions are still fundamentally relevant today, and perhaps even more so in our politically damaged NHS. As doctors we need to remember who to put first, despite the huge pressures on us from political masters to meet targets and dumb down to ‘tick box medicine’. We must protect those who cannot speak up for themselves, and care equally for those with mental health issues, despite the NHS under-funding their care.

I have enjoyed learning about the Hippocratic Oath, and am glad that, despite never having sworn it aloud,  I live by it every day.

 

 

Flu’ – don’t let it spoil your Christmas break

studenthealth minor illness, Uncategorized ,

We all get coughs and colds over the winter months, but Influenza (aka ‘Flu’) can really spoil your Christmas break. The saying goes that you can differentiate between Flu and a simple cold by the infamous £50 flu test…

 

‘If there was a £50 note on the floor, would you get out of bed to fetch it?

If you would then you have a cold, if you wouldn’t then you have Flu!’

 

Influenza is characterised by the sudden onset of fever, chills, headache, muscle pain, and extreme fatigue. Other common symptoms include diarrhoea and vomiting, a dry cough, sore throat, and runny or stuffy nose. For otherwise healthy individuals, influenza is an unpleasant but usually self-limiting disease with recovery typically within 2 to 7 days. Symptoms in children can last up to 2 weeks.

 

Transmission is by droplets, aerosol, or through direct contact with respiratory secretions of someone with the infection. Influenza spreads rapidly, especially in closed communities. Most cases in the UK tend to occur during an 8 to 10-week period during the winter.

 

Flu can be more severe in certain people such as those who are elderly, pregnant, have reduced immunity or those with an underlying health condition. Anyone in these risk groups is more likely to develop complications of flu, such as pneumonia (a lung infection), so it’s recommended that they have a flu vaccine every year to protect them.

 

The injected flu vaccine is offered free of charge on the NHS to anyone with a serious long term health condition as listed below:

 

  • chronic (long-term) respiratory disease, such as asthma (that requires inhaled or tablet steroid treatment or has led to hospital admission in the past), chronic obstructive pulmonary disease (COPD) or chronic bronchitis
  • chronic heart disease
  • chronic kidney disease
  • chronic liver disease, such as hepatitis
  • chronic neurological conditions, such as Parkinson’s disease or motor neurone disease
  • diabetes
  • problems with your spleen – for example, sickle cell disease, or if you have had your spleen removed
  • a weakened immune system due to conditions such as HIV and AIDS, or as a result of medication such as steroid tablets or chemotherapy

 

If you don’t qualify under these criteria you can still seek a private flu jab via many of your local pharmacies.

 

Studies have shown that the flu jab definitely works and will help prevent you getting the flu. However, it won’t stop all flu viruses, so it’s not a 100% guarantee that you’ll be flu-free. The vaccine stimulates your body’s immune system to make antibodies to attack the flu virus. If you catch the flu virus after you’ve had the vaccination, your immune system will recognise it and immediately produce antibodies to fight it.

 

So, if your eligible then call the office at the Students’ Health Service and get booked in for your free flu immunisation, and have a Very Happy (and Flu free) Christmas!

 

http://www.patient.co.uk/health/influenza-and-flu-like-illness

 

http://www.patient.co.uk/medicine/influenza-vaccine