Health Information

Every teenager will get spots at some stage, but this simple fact doesn’t make it any easier when they suddenly appear for no apparent reason. Growing up is difficult enough without having to worry about scarring from infected spots and lack of self-confidence in public. Some people are affected much more than others, but you can rest assured that there are effective remedies available – it’s only a matter of finding the best treatment to suit your individual needs.

How do spots develop?

Small glands in the skin naturally produce an oily substance called sebum, which helps protect skin and hair. Pores on the skin surface can become blocked with a mixture of dead skin and this oily substance allowing infection to develop. Pus builds up behind the blockage and the gland swells.

What are the symptoms?

Blackheads, whiteheads and larger red coloured spots tend to appear mainly on the face, but are sometimes found on the neck, chest, back and upper arms. Sometimes the affected area may even appear as a rash. If you develop large lumps or have remaining scars, it is advisable to seek help from your doctor.

Common causes

Acne has been the subject of many old wives tales in the past. Research has shown however that, contrary to popular belief, diet has little, if any, effect on spots. Eating 'too much crisps and chocolate' is not a cause. It is also a myth that acne is caused by dirty skin. In fact, washing too often, particularly with strong soaps, can be an aggravating factor.

Scientists are in general agreement that changes in hormone levels around puberty are probably the most common cause of spots. It is also becoming increasingly clear that stress can be related to acne. Certainly, general ill health and being 'run down' affect the skin, making acne worse.

What can I do about it?

Avoid harsh soap. Skin can normally be kept clean with fresh water
Try to avoid cleansers containing alcohol
It is beneficial for girls to use water-based make-up only
Don't squeeze spots! This may cause permanent scarring
Mild to moderate acne may be effectively treated with a product from your local chemist. If your acne is severe, or does not respond to these lotions, speak to your doctor or pharmacist
In severe cases, your doctor can prescribe a long-term course of antibiotics. If your acne is particularly bad, your GP may refer you to a specialist for some more powerful antibiotics.

Allergies

Do you have an allergy?

Allergies are caused by our body’s own defence system. When the body is exposed to specific substances or allergens, it produces antibodies as an immediate response. The reactions can range from a mild flush to a serious and life threatening condition. More often than not, many people will suffer from allergies for years without realising it. The following are examples of common allergies:

Pollen, house mites, pets and dust
Hay fever and allergic asthma
Eczema. Contact dermatitis is easily recognised
Itchy hives. Nettles tend to bring out hives in most people but foods like strawberries or seafood can also be causes

What are the Symptoms?

Immediate reactions to specific allergens can affect the whole body or just around the contact area. Symptoms may include:

Itchiness
Blotchy red rash over the body
Blocked or runny nose
Eye irritation
Fluid retention

However, it is important to note that more serious reactions can lead to:

Shortness of breath
Tightness of the chest
Swollen lips or tongue

Common Causes

There is a wide range of possible allergens and the reaction depends a great deal on your own body and its individual reaction. Strong allergic reactions are more likely if you suffer from hay fever, asthma or have had a reaction to a certain substance in the past.

Common allergens include:

Foods. Peanuts, seafood and strawberries are particularly common causes of reaction in susceptible people
Dairy and grain produce (normally associated with long term allergies)
Soap powders
Hair dye
Latex products such as rubber gloves, plasters or condoms
Nickel jewellery or watches

What can I do about it?

Once you find out that you’re susceptible to a particular substance it is always best to avoid that particular allergen as much as possible. Alternative foods or material are often available which do not provoke an allergic response.

You can also take care by wearing hypoallergenic gloves or using a filter in the hoover to remove dust and mite droppings. It is also advisable to check food labels for potentially allergenic ingredients, such as peanut products.

If you do come into contact with a known allergen, wash off the affected area if the suspected allergen is still on the skin. Alternatively, if the skin becomes particularly irritable, try bathing in a cool bath with a large spoonful of baking soda.

If you are unsure, it may be best to ask your pharmacist for something to treat the allergy.

Susceptible people should carry antihistamine tablets in case of a reaction.

If you have ever had anaphylactic shock, you should also carry injectable adrenaline from your doctor.

Caution

Serious allergic reactions can be fatal. Long term reactions can cause debilitation even after there is no further contact with the allergenic substance. Anaphylactic shock is an extreme allergic reaction. Immediately after contact there is difficulty breathing, itchiness, swelling of the lips and throat, drop in blood pressure, and finally collapse.

Dial 999.

Childhood Immunisation Programme

Changes to current childhood schedules to be implemented at the end of September 2004.

The following changes have occurred following recommendation by the Joint Committee on Vaccination and Immunisation (JCVI) – the independent expert advisory body.

The first main change is that the use of oral polio vaccine drops will no longer be used and an inactivated polio vaccine (IPV in injection form) will be used. The advantage of using the IPV is that it does not carry the risk of vaccine - associated paralytic polio, which can be a problem with the live vaccine as it is excreted in the baby’s faeces following immunization.

The second change is the use of acellular pertussis instead of whole-cell pertussis vaccinations (whooping cough vaccine). The advantage of this switch is that they cause less local and systemic reaction when compared to the whole cell and they are just as effective in providing immunity.
These two new components to the immunising regime have been added to the other vaccines already routinely given which are diphtheria tetanus and Hib.

The new vaccine is called Pediacel ( DTaP/HIb/IPV). Your child will have 2 vaccines the Pediacel vaccine along with the Meningococcal C which is given separately.
This is given to babies at 2, 3 and 4 months of age. You will be called routinely to the surgery for these vaccinations. The new vaccines will be used once we have received our supply in the meantime the current vaccines will be used. If your baby starts its course of immunisation using the original schedule there is no problem with completing the course with the new vaccine.

The pre school booster given between 3 years and 4 months and 5 years will also contain the acellular pertussis and the IPV ( vaccine form of polio) along with diphtheria and tetanus Your child will therefore have 2 vaccines the above and the MMR booster.

For the teenage booster at 13-18 years the diphtheria (low dose) and tetanus will also include the IPV.

We appreciate that preparing your child for immunisation is stressful which is heightened by new changes. Information leaflets will be made available on request and of course we are happy to discuss any issues which you have.

Useful website www.immunisation.org.uk

Diabetes

What is diabetes?

Diabetes occurs or develops due to a loss of control over the amount of glucose in the blood. The condition is usually diagnosed by finding sugar in the urine, and sometimes by testing the levels of blood sugar at different times of day.
There are two types of diabetes each with different causes and treatments. The first type is often referred to as insulin-dependent diabetes, where the body produces little or no insulin. Type I affects about 1% of the population in Britain and requires constant treatment and checking of the level of sugar (glucose) in the blood, as well as a regular watch for complications.
Type II diabetes or what is sometimes described as ‘maturity-onset diabetes’, occurs later in life and is usually linked with obesity. Here, the condition develops when the body’s cells don't react to the insulin naturally produced.

What are the Symptoms?

In untreated diabetes the main symptoms are:

Thirst
Production of excessive urine
Wasting of the muscles, sometimes leading to weight loss

Main Causes

The cause of the disease is often dependent on the particular type of Diabetes diagnosed. It is either caused by the failure of the pancreas to produce the hormone insulin, or else where cells fail to use the body’s insulin properly. Insulin is essential for the building up of fats and proteins, which are important in maintaining general health and the body’s immune system.

A virus infection may be part of the cause, along with an inherited vulnerability to the disease.
Obesity is the most common cause of Type II Diabetes. A change in lifestyle and healthy eating can greatly reduce the risk of developing this Type of diabetes later in life.

Treatment

Type I diabetes is treated with insulin injections and diet and exercise control, all monitored by frequent checks of the blood sugar levels. A small portable instrument is used to check blood sugar.
Type II diabetes can be controlled by a combination of weight reduction, drugs and, if severe, insulin injections.

Complications

Diabetes that is not under control can eventually cause damage to the blood vessels. This damage affects especially the eyes, the kidneys, the circulation to the legs and the nervous system.
Diabetes causes impotence in about 40% of diabetic men, but thankfully that is treated effectively with modern drugs. Diabetic disease of large blood vessels may lead to narrowing and severe interference with the blood flow. Older people with diabetes are more likely to develop bedsores and serious infections of their feet or legs, partly as a result of poor blood supply, but also because of the lack of sensation from nerve damage.
Pregnancy causes special problems for diabetic women since diabetes tends to cause large babies, which increases the likelihood of problems. For this reason, pregnant diabetic women tend always to have their antenatal check-ups in hospital, or in a diabetic clinic, where a close watch on blood sugar and fine tuning of insulin dosage is possible.

Insomnia

The amount of sleep required by different people varies from 3 to 4 hours to 10 hours , the average being about 6 to 7 hours. As we get older we require less sleep mainly due to increased inactivity.

The reasons for poor sleep are numerous:
1. Anxiety about being awake. Most people actually sleep for longer periods than they believe.
2. Depression and anxiety. Sleep will improve as the depression resolves.
3. Stress due to a work or family problem.
4. Stimulants such as caffeine, alcohol and nicotine.
5. Sleep apnoea in obese people due to temporary collapse of the large airways and a reduction in oxygen levels.
6. Medicines such as steroids , beta blockers, anti depressants and water tablets.

Sleep may be improved in a number of ways:
1. Routine at bedtime, only going to bed when tired and avoid cat napping during the day. Waking at the same time each morning regardless of hours spent asleep.
2. Winding down before bed e.g. listening to relaxation tapes , drinking a warm caffeine free drink.
3 Avoiding stimulants such as alcohol and caffeine
4 Avoiding strenuous exercise close to bedtime
5. Avoid large meals before bedtime .

Sleeping tablets should not be prescribed routinely but are useful in certain circumstances e.g. bereavement for short term use. Dependence and tolerance are the main problems.

Useful websites include the Sleep Council’s website at www.sleepcouncil.org.uk

Pre–Conception and Early Pregnancy

Folic Acid.

This should be taken at a dosage of 400mcg before conception and continued until 12 weeks of pregnancy. Folic acid reduces the incidence of neural tube defects such as spina bifida. Folic acid may be purchased at pharmacies and supermarkets.

Diet.

A healthy balanced diet with plenty of vegetables rich in folic acid such as spinach, broccoli and potatoes is advisable. Fish and meat are also important as they are a valuable source of protein.
Certain foods should not be eaten such as liver which is high in vitamin A which can cause problems in pregnancy.
Listeria is a bacteria found in soft cheeses such as brie and camembert, pates ,chilled foods and ready made meals. Pregnant women are more susceptible to this bacteria which may result in miscarriage, stillbirth and neonatal infection. Thus, these foods should not be eaten during pregnancy.

Smoking

Smoking during pregnancy results in higher rates of miscarriage, premature birth, stillbirth and low weight babies.Chest infections ,asthma and sudden infant death syndrome are commoner in the offspring of parents who smoke .Pregnancy is therefore a good time to stop smoking with benefits for both mother and baby.

Alcohol

Studies are on going as to the safe amount of alcohol in pregnancy. Current advice would be little or no alcohol whilst pregnant.

Animals

Pregnant women living on farms should avoid contact with sheep and lambs at lambing time since they may be infected with bacteria such as chlamydia, toxoplasma and listeria. Toxoplasmosis may cause defects in an unborn child and is found in cat faeces and raw meat which should be avoided.

Infections

Coughs and colds are rarely harmful to the unborn baby, however rubella (German Measles) can cause defects in the foetus. A blood test will be performed in early pregnancy to determine whether or not the mother has immunity to rubella. Chicken pox can also harm the developing foetus and blood tests may be performed to chEck for immunity

Full information on the above topics is readily available from the midwife or GP in the form of leaflets or videos.
Pre –Conception and Early Pregnancy

Folic Acid.

Diet.

Smoking

Alcohol

Studies are on going as to the safe amount of alcohol in pregnancy. Current advice would be little or no alcohol whilst pregnant.

Animals

Infections

Full information on the above topics is readily available from the midwife or GP in the form of leaflets or videos.
HFfD 9/04

Prostate Problems

The prostate gland is found in males only and lies beneath the bladder.The prostate helps to make semen. With increasing age after 50, the prostate gland increases in size .This process is known as benign prostatic hypertrophy and affects approximately 1 in 3 men over 50.
The symptoms are as follows:

-Hesitancy-difficulty in starting the flow of urine
-Poor stream
-Dribbling
-Poor emptying
-Frequency-passing urine often
-Urgency-having to rush to urinate

Various tests are performed:
-A rectal examination to determine the size of the prostate
-A PSA blood test which is a screening test for prostate cancer and is controversial
-An urine test and blood test to check for kidney function

Subsequently, a referral to an urologist may be made if symptoms are significant.
Treatment is dependent upon the severity of the symptoms and several drugs are available to relieve symptoms. One group of drugs relaxes the prostate thus improving outflow whilst another group blocks the male hormones causing the prostate to shrink..
Surgery may also be required.e.g. TURP (Transurethral resection of prostate)

An useful website for further information may be found at www.pha.u-net.com which is the website of the Prostate Help Association.

Steroid Tablets

Steroid tablets e.g. prednisolone are used in many conditions to reduce inflammation. Examples of such conditions include asthma, rheumatoid arthritis, polymyalgia rheumatica, temporal arteritis.

Many patients are concerned about the potential side effects of steroids. Rarely are there side effects following a short course for one to two weeks and the higher the dose, the greater the risk of side effects.

Main side effects of steroids include the following:

1. Weight gain and puffiness of the face
2. Suppression of the immune system resulting in reduced immunity to infections such as chicken pox or recurrence of dormant TB.
3. Osteoporosis or thinning of the bones which may be offset by co-administration of e.g. HRT
4. Raised blood sugar especially in diabetics.
5. Raised blood pressure
6. Thinning of the skin and bruising.
7. Muscular weakness
8. Stomach ulcers and indigestion
9. Changes in mood such as depression

Steroids should not be stopped suddenly if they have been taken for several weeks. Those who take long term steroids should carry a ‘Steroid card’ with information regarding dosage and the nature of their condition which is available from the doctor.

A Helpful Approach to Quitting Smoking.

If you are a smoker, every time you visit the surgery you are probably asked about your smoking by the Doctor, Practice Nurse or Nurse Practitioner. This is with good reason. There is no doubt that smoking as little as two cigarettes a week can be addictive. Smoking can have damaging effects on your health, reducing your life span by 15 years and killing 120,000 people per year with smoking related illnesses.

It is worth quitting both for health and financial reasons, and we are here to help you. All the medical staff at the Surgery are dedicated in encouraging and aiding you to stop smoking.

Are you ready to stop smoking?

Obviously you need to be motivated to stop. You don’t have to do it alone. The Doctor, Practice Nurse, Nurse Practitioner and the specialist smoker’s clinic can provide you with the best method of cessation and offer encouragement. Using this support group will ensure higher success rates in your attempt to stop smoking.
To contact your local smoking cessation clinic call Glenda Morgan on 0798038684 this is a free NHS clinic run at Cross Hands Health Center on Tuesday evenings (other venues are also available).

Our Nurses will also be able to provide you with information, especially if you already attend the diabetic, asthma or coronary heart disease clinics.

What medications are available to help?

Nicotine replacement therapy ( NRT)

These can double your chances of stopping. There are six products patches, gum, nasal spray, inhalator, tablet and lozenge. Your pharmacist can give you advice as to which one will suite you best and all may be bought in ordinary shops. Alternatively you may discuss the best option with your Doctor and all can be obtained on prescription.

Zyban

This is the trade name for bupropion hydrochlorine which comes as a tablet form, again it doubles a smokers chance of stopping. Zyban is a prescription-only medicine and you need to discuss your suitability for this type of smoking cessation aid with your Doctor.

Remember you are not alone.

Useful contact numbers.

Smokers’ Helpline Wales 0800 169 0 169

Smoking cessation service 0798038684

www.givingupsmoking.co.uk

www.healthwales.org.uk

www.nosmokingday.org.uk

Good luck / Pob lwc

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