Online resources for medical matters

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For someone who never went to medical school Dr Google seems to be an incredibly popular and sought after ‘specialist’.  A significant number of people will turn to the internet for information and advice before seeking professional help, and this is a good idea in the right context. There are some fantastic resources out there, and so I thought it might be helpful to list a few of them, to improve the quality of the results our patients are getting when they go online, and to save time for those who get drawn into elaborate and complex searches featuring more and more worrying symptoms and diagnoses!

First off, a safe and reliable place to start for all medical queries;

www.patient.co.uk

Next up, for info on local services, how the NHS can help, conditions, and health costs;

www.nhs.uk

And for travel advice

www.fitfortravel.nhs.uk

Lastly for mental health advice and support;

www.mind.org.uk  or

 www.bigwhitewall.com

which is an award-winning online mental wellbeing service. It offers the first online pathway for mental health and wellbeing, placing people at the centre of their own care.  It enables people to access well governed, safe therapeutic services through self-referral from the comfort of their own homes.

Apps;

The NHS has also realised the need for a reliable single source of credible and safe online resources and has recently launched its Health Apps Library, at last month’s NHS Healthcare Innovation Expo in London.

Here at SHS we are particularly interested in the ‘Patient Access’ App, as we already have the online facility allowing our patients to book appointments and re order repeat prescriptions via the internet, but it would be brilliant to have a phone app too, making it potentially even simpler. We will be looking into how to adopt this app, but it is something that the local health community may need to fund, so watch this space.

The Sound Doctor App; An Audio app which enables patients to listen to information about their long term conditions and therefore help them look after themselves more easily and get the best out of life.Leading doctors, nurses, patients and other relevant health professionals have been interviewed to provide a really comprehensive look at a number of long term conditions.All the information is presented in short chapters of between 3 and 5 minutes each with several interviewees in each chapter.

ActiveMe App; Developed by NHS experts in CFS/ME, activity record charts are widely used to help patients and
practitioners work together to develop a daily baseline of energy use before increasing it in regular steps
to enable you to achieve your goals.Fast, easy, portable and discreet, ActiveME can help you balance your activities.

Type 1 Diabetes (Alcohol guide) App; Having type 1 diabetes means that it is important to know how to keep safe when having alcohol. This guide aims to help you find out what to do to keep safe and how alcohol can affect your body.This App has been designed based on ideas and suggestions provided during the qualitative interviewing of young people with type 1 diabetes aged between 18 and 21. It has been developed in collaboration with the Poole Hospital Diabetes Centre in the UK for use by their patients.

PillManager App; helps you manage your medications, never forget them, and also helps with re ordering them too.

These are just a few to get you thinking.

See our website for loads more Useful Links

http://www.bristol.ac.uk/students-health/links/

 

Running Late AGAIN?!

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“OMG! She’s running late AGAIN! I’ve got a lecture in half an hour… what shall I do…? I’ll just wait for a bit and see… how can she always run late? What’s the point of booking an appointment time if I am never seen on time?! Grrrr…”

Meanwhile, in a room down the corridor…

“OMG I’m running late again! Why does this always happen to me? I hate keeping people waiting, but it’s so difficult to balance the lists of ailments that some people bring, and the complex mental health issues of others. All in 10 minutes. Now the phone’s ringing…

Yes, ok I’ll speak to that mum later, send me an email and I’ll call her back once we have consent from the student.

Now who’s at the door, grrr, an urgent prescription, ok just this once, but please leave it in my basket next time.

Right, where was I? Write myself a note to check if those results are back this afternoon.

Ok, next person, ‘buzzzz’.

Now the minutes are ticking by as they gather their things together in the waiting room… then strolling down to my door, and here we are…

Hi, come in have a seat. How can I help today? Three things to discuss? OK, let’s see what we can do…

Sorry the phone’s ringing, let me just see what that is, the on-call biochemist? Ok yes, put them through. Sorry, I just need to ask about a result…

Now where were we?

Panic attacks, and depressed you say, ok, tell me all about it…”

 

At the Students’ Health Service we are very aware of time keeping issues, and that quite often our patients have to wait to see us. We would, of course, rather that this was kept to a minimum, but we hope that you will understand that there are some things that can’t be rushed, and that we try to give each person the time they need, when they need it.  Everyone’s time is precious, we really do understand that.

We have all taken part in extra communications skills training in the last year, to try to identify more efficiently ways of working, but there will always be difficult situations, and therefore we hope that you will understand the challenging line we tread when trying to run to time.

 

Thank you for being patient.

 

Art and Wellbeing

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Art and Wellbeing by Dr Emma Webb

Appreciation of beauty is a part of maintaining happiness whether you find it in the arts, the natural world, human connections or other experiences. It has a positive effect on our sense of well being. Appreciation of art can enrich us through its message whether that is political, sociological or psychological or more simply via its direct emotional effect.

There is a broad spectrum of evidence to show how the arts achieve positive outcomes for patients, for staff, for the patient-staff relationship, for hospitals, mental health services and in the health of the general population.

In healthcare environments the experiences of patients and staff can be improved by artwork. Participation in the arts can be a valuable tool for improving one’s own physical, social and emotional wellbeing. Arts are now used in medical training to gain insight into patient health and to explore ethical issues as well as being used as a psychotherapeutic treatment for mental health problems.

Visiting Bristol Museum and ArtGallery recently, I was particularly drawn to the sculpture ‘A Ton of Tea’ by the Chinese contemporary artist Ai Weiwei. It is unexpected and as well as its political symbolism, also has an amazing texture and fragrance when you get close to it.

The ‘Sands of Time’ by David Maitland is a beautifully colourful photographic depiction of the skeletal remains of sea invertebrates found in a sample of sand – fascinating, microscopic beauty.

Back at Students’ Health Service we are looking forward to enhancing our own surroundings with the addition of some artwork to our walls. I hope that it will be engaging, interesting and enjoyable for all our visitors.

 

You can visit;

BristolMuseum and ArtGallery – ‘No Borders’ contemporary art in a globalised world. Free exhibition until June 2013

BristolMuseum and ArtGallery – Wildlife Photographer of the Year

 

Powdered willow bark for your headache?!

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On a daily basis I am amazed by the number of students who have seemingly no idea what to take for their pain or fever. The same issue has been noticed by our colleagues at the local Emergency Department, who are somewhat frustrated with having to deal with people who haven’t yet tried a simple painkiller for their sore throat, headache, or sprained ankle.

So I thought it might be useful to write a short blog about painkillers (or analgesia, to use the technical term!), for future reference next time you have a pain somewhere, or a raised temperature.

Salicin, from powdered willow bark, is a method of pain control dating back to Hippocrates in the 4th century BC. Over the centuries it was modified, and since 1897 we have known it as aspirin.

Paracetamol is much newer, coming from France originally, then modified in Germany in 1899, to a form very similar to the one still manufactured in huge quantities today.

Indomethacin was the first Non Steroidal Anti Inflammatory Drug (NSAID) in the 1960s. The commonest NSAID we recommend is ibuprofen.

Opioids have been around since as early as 3400BC and have caused problems alongside bringing benefits, ever since! Methadone came along in the 1930s.

There is a reason that these medications have been around for a long time, and that is because they work. I regularly encounter a strange reluctance to take anything at all, despite seeing patients with raging sore throats or disabling headaches because ‘it will mask the symptoms for you, doctor’, or it’s seen as a form of ‘personal failure’ to need a medicine.

I have to admit that I am baffled by both approaches, as any significant clinical signs will not be ‘masked’ (other than fever, and we ask about history of fever, not just current fever), and how can it be a ‘failing’ to use the wonders of science to treat illness. We wouldn’t deny another pain relief, so why do we deny ourselves?

So please, if you are suffering with pain or fever, and are not allergic to these medications, try the following from the pharmacy or supermarket (no prescription required);

 Paracetamol;               1 gram (2 tablets) up to 4 times a day (adult dose)

 Ibuprofen;                    400-600mg 3 times a day with food (total 1800mg)

 Cocodamol;                 8/500 tablets, 2 to be taken 4 times a day (instead of paracetamol)

Paracetamol and ibuprofen are synergistic and therefore taking both will give you even greater benefit.

Read the packets for dosage and side effect information, and if unsure ask the pharmacist for advice.

 Don’t suffer, take something and take comfort in the fact that our ancestors were onto a good and painfree thing!

Sit less, Move more!

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Ignoring your parents, and other ways to save your life

by John Wilford

 

“Don’t do that”

“Put that down”

“Don’t talk with your mouth full”

 Familiar ‘instructions’ heard by kids, of all ages.  Now the truly disgusting ones…

 “Sit down!”

“Sit still!”

 Mum, you got it so wrong.

 If you are reading this sitting down, please, get up. Standing comfortably? Then we’ll begin…

 Sitting is killing us.  It has become a ‘goto’ topic for the BBC on slow news days, and a recent article on the Harvard Business Review blog condemns sitting as our generation’s smoking.  There is an increasing body of evidence, generated by clever academic types on both sides of the Atlantic, showing just how bad sitting is for us.

Research in the USA shows people spending more time sitting (9.3 hours per day) than asleep (7.7 hours).  Like it or not, the UK is in the same ballpark.

Add up the time spent sat at your desk, in the library, in lectures, seminars, meetings and tutorials.  Time spent sat in the car or on the bus. Then there’s ‘leisure sitting’ – watching TV, at the computer or games console.  Sitting, just sitting. Oh, sit.

Further research suggests that if you sit for more than 6 hours a day, you are 40% more likely to die within the next 15 years than someone sitting for just 3 hours.  The bombshell is that this is true even if you exercise. Sedentary behaviour (sitting/lying whilst awake) is not just a lack of physical activity; it’s bad in its own right. As soon as you sit down, your leg muscles switch off, calorie burn drops to 1 per minute and after 2 hours your ‘good cholesterol’ has dropped 20%.  Whether you are an exerciser or not.  Higher rates of sedentary behaviour correlate with greater risk of mortality, independent of levels of physical activity. 

Sitting is a habit – and a bad one.  Like smoking, or biting your nails (Sorry Mum…).  It’s automatic and easy.  But it is a habit that can be broken. 

Look at what makes you sit, and where and when you could do without it.  On the phone? Stand up.  Having a short meeting? Ignore the chairs. On the laptop? Raise it up and stand (use window sills, cabinets, even the ironing board). This is before we even get to walking more – park your car further away from destination, take the stairs not the lift, etc etc…..

Yes, there are times that you will need to sit.  But limit it.  Get up and move around frequently. Swap standing and moving for sitting wherever possible.

 

Take a stand against sitting – sit less, move more.

Specialist Treatment for Eating Disorders

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Despite references to eating disorders in texts dating from the time of the ancient Pharoes, and even a mention in Shakespeare’s Measure for Measure, the development of effective treatments has been slow. 

However, a treatment called cognitive behavioural therapy (CBT) is now yielding results.   Indeed, as a result of research demonstrating its effectiveness, CBT is now recommended as the first line treatment for people who have not responded to a self-help approach.  

 At the heart of CBT lies the deceptively simple idea that eating disorders are driven by an irrational fear of uncontrollable weight gain.  This fear leading to counterproductive forms of dieting which, whilst intended to prevent weight gain, often have the opposite effect and thereby cause more distress and further reinforce the original fear.  CBT tackles the belief that strict diets are the only way to prevent weight gain by encouraging clients to see what really happens when they give up dieting and take up healthy exercise.

 For many with eating disorders the idea of consuming between 1,900 and 2500 kilocalories a day just to see what happens is a terrifying prospect and indeed the treatment is not for the faint-hearted.  But what most people find is that their body burns the energy they consume and their weight remains within healthy limits. 

 Treatment therefore provides a safe and supportive environment in which to take the plunge, give up dieting and see what happens.  And, at the end of six months treatment, if people don’t like the results of their experiment in normal eating, then they are free to return to the diets they were using beforehand.  

 Evidence suggests that about three quarters of people who complete the treatment find it useful.  Whilst this is a promising start, the quest to refine the treatment and thereby improve recovery rates goes on.

Doing CBT is a substantial commitment.  It takes time, energy, hard work, determination, perseverance and courage.  As I tell my clients, “you have to do all the hard work yourself”.  But if living with an eating disorder is ruining your life then it might be worth considering if treatment could be right for you.  If you’d like to talk to someone about whether CBT could help you overcome an eating disorder your GP will be happy to discuss it with you and to make a referral for treatment if necessary.

http://www.bristol.ac.uk/students-health/services/eating-disorders/

 

Chinese New Year 2013!

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Happy Chinese New Year to All Our Students.

A blog by Dr Clare Grant

Over the weekend, Chinese New Year was celebrated all around the world, including here in Bristol. Although Chinese students at the University weren’t lucky enough to get a statutory holiday to celebrate the New Year, I’m sure they enjoyed welcoming in the year of the Snake. Chinese New Year traditionally marks the end of the Winter Season, so that’s already one good reason to celebrate….roll on some Spring-like weather! Traditionally, it’s also a very family orientated time of year, when relatives get together and enjoy good food and each other’s company.

There are so many ways of keeping in touch with family once you leave home and come to University, even when leaving home means travelling thousands of miles to study in a different country. In fact, sometimes it feels hard to escape family ties: there always seems to be some way in which they can contact you! But, as we all know, it’s at family times like Chinese New Year, when the rest of our relatives get together without us, that we can feel particularly isolated and unsupported.

There are many International students at the University, with the largest single group being  from China. The personal and professional benefits of spending some time abroad studying in Bristol can be huge, but it can also be challenging studying away from home. All of the Bristol University Support Services (Students’ Health Service, Student Counselling, Disability Services, Multifaith Chaplaincy and Careers Service) are here to help our International Students as well as our home ones. These support services may be quite different to the ones provided by Universities in other countries, so it’s definitely worth having a look at their individual websites to see what they offer and how they might be able to help you.

Here at Students’ Health Service, we are experienced in helping International Students with their medical problems, wherever they come from in the world. In any one day, we can see students from at least 15 different countries! We are also aware of the physical and psychological health problems that can be associated with coming to study abroad. If you are experiencing health problems, please do make an appointment with one of our doctors or nurses, (our reception staff will help you decide who it’s best to make the appointment with): whichever country you come from, we are here to help you whilst you are studying at Bristol University.

 

Eating Disorders Awareness Week 11th Feb 2013

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Student-Run-Self-Help (SRSH) is a national charity that aims to support students suffering from eating disorders by providing a safe space for students to talk within student-run group sessions. We are driven by young people’s personal experiences of living with mental health issues and aim to provide a confidential, non-judgmental, welcoming environment for those who need support.

“I know I owe my recovery to having amazing people to talk to, people who really understood. Through SRSH my ambition is to ensure that all students have someone to talk to, someone who understands!” (Nicola Byrom, the founding director of SRSH)

In Bristol, we run sessions every alternate Monday in the Just Ask office on the 4th floor of the Student Union from 6.30-7.30pm. We welcome both sufferers and their friends/family. We bring together people who understand each other’s problems and although we know it can be difficult to talk, in a group setting everyone is there to help each other on the road to recovery.

Eating disorder awareness week is the 11-15th February and we feel this is a great opportunity to try and increase students understanding of what an eating disorder is, and what they may be able to do to help friends who may be suffering. This quote provided by a student recovering from an eating disorder simply re-enforces how important it is to talk.

‘ After years of treatment, medication and therapy, the one thing that actually enabled me to overcome this isolating, life-destroying illness, was talking to friends and family. When I started to let others in and shared every little step I made, it made the long road seem much shorter, easier almost, and certainly there was no turning back. There are people out there, lots of them willing to help, and the SRSH team are some of them, and if you are prepared to accept it, recovery is possible.’

We will be running a campaign called “Something Worth Talking About” in the foyer of the Students’ Health Service, Hampton House, on Monday 11th February where people will have the opportunity to learn more about the facts and fiction of eating disorders through various interactive activities.

There will also be a “How to Save a Life” workshop on 21st February at 5.30pm (Venue: MR6 Large, in the Students’ Union) for friends of sufferers. This workshop provides support and invaluable advice for the friends of sufferers. SRSH ran one last term, and with the feedback from attendees, decided it was so successful that it would be repeated.

Although the SRSH team provide a space for sufferers to talk, they are not professionals, and students are encouraged to seek care and advice from the University of Bristol’s Students’ Health Service and Student Counselling.

For more information on the national charity visit: http://www.srsh.co.uk/

Find us on Facebook: http://www.facebook.com/pages/UBU-eatingdisorders-SRSH/168537216577838?fref=ts

Or visit our union webpage: http://www.ubu.org.uk/justask/supportgroups/eatingdisorders/

I tried self hypnosis for my anxiety! You could too… a student writes…

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When I approached the Students’ Health Service to seek help with my study-related anxiety, night-time panic attacks and insomnia, I was really not sure what to expect. Although I knew they would have heard it all before, I did not anticipate such swift and effective support. Dr Grant, who I was able to see within a couple of hours of my panicked phone call, suggested a number of helpful options including referring me to a colleague in the Centre for Sports, Exercise and Health who introduced me to a range of approaches, including neuro-linguistic programming (NLP). In just an hour Matt Edwards had taught me a simple method of recalling a desired mental state: in my case, a state of calm and focused concentration on the task at hand. I had never attempted anything like this before, largely due to a deep suspicion of such techniques. I like to think of myself as a ‘rational’ person, not usually drawn to ‘alternative’ medicines or therapies. I felt nervous and a bit silly, but prepared to give it a try. In a private and comfortable office I explained that I was hoping address study-related anxiety and improve my concentration and focus. To my relief this was all the detail I had to give: this was not a counselling session! Matt outlined a range of approaches and we agreed to try a certain NLP technique. He told me to close my eyes and imagine a situation when I had felt calm, focused and in control: the mental state I wanted to be able to recall. He then talked me through a process of cementing in my mind what I could see, hear and feel in this situation. This took about ten minutes or so, but after imagining and magnifying that feeling in my mind’s eye, I felt that I really could return to it any time. Matt explained that in NLP this process is often accompanied by associating this mental state with a physical ‘anchor’: for me, this became a single word. Now, when I say that word to myself, I am able to recall that feeling of being calm and in control. I have used it several times since in class presentations and at home, particularly in the evenings, when my workload seems too much.

Apparently NLP is about being able to visualise what you want to achieve, and then re-create it for yourself by placing yourself mentally in that situation. I am being honest when I say I can’t believe it works, but it really does. I really would recommend anyone else at the end of their academic tether to give it a go – it can’t hurt, and if you believe in it even a little bit, it works wonders.

For a discussion about a referral to Matt Edwards book an appointment with a GP at Students’ Health Service.

Self Injury; a paradox…

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It is a strange truth that people self harm to make themselves feel better.

Some people have a glass of wine after a bad experience, some eat a huge bag of crisps or a bar of chocolate. But some people cut themselves, or burn their skin, take an overdose, or punch a wall. All of these options are a human way of coping with stress, though not a healthy way.

Most days at Students’ Health Service we see male and female students who have recently harmed themselves. Our nurses are very sympathetic, brilliant at wound care and completely non judgmental. The GPs would like to help you too, and discover what’s behind the self injury and distress. We are not easily shocked and we have seen many unusual ways that students harm themselves, secondary to depression, anxiety, obsessive thoughts or psychosis.

Alcohol usually makes self harm more frequent, or the injury worse.

Nationally self harm is thought to affect about 5% of people, though this is likely to be an underestimate (Meltzer et al 2002). In a school survey 13% of young people aged 15/16 reported having self harmed at some time in their lives, and 7% in the previous year (Hawton et al 2002).

It is important to assess and treat those who self harm, as the behaviour is often related to an underlying mental health condition, which, if treated, may lead to improvement not just of the depression/ anxiety/ schizophrenia etc but also of the self injury.

If you would like help with self injury, or would like to talk about your mental health in general, please come and see us soon. Don’t forget that the Student Counselling service is also there to help, and the team is very experienced in supporting students with such issues.

 Other support in Bristol;

Contact the Self Injury Self Help Bristol organisation, who provide services for men and women with self injury issues. They run support groups, and also run workshops related to achieving good mental health in general.

Email; sishbristol@yahoo.co.uk

 Phone; 0117 927 9600

Or, Bristol Crisis Service for Women; 07788142 999

Runs a text support service for managing your self injury and emotional distress.