What is Asthma?

Asthma is the temporary narrowing of hypersensitive airways due to inflammation.
Salbutamol (the blue puffer) temporarily relieves asthma by opening up the airways for a short period of time.  If you find yourself using the Reliever more than 3 times a week, then you should also be taking a Preventor (Clenil) every day. The Preventor reduces inflammation around the airways. If you have a Preventor but still find you are using the Reliever too often (more than 4 times a day or in the middle of the night more than once a week), you should book into see the Nurse for a review.

Hyperventilation it isn't the whole story though. Lots of people (including asthmatics) take very frequent shallow breaths, rather than long deep breaths and this gives a restricted feeling. Sometimes it can even give tingling in the hands. Learning to breathe properly can help some people and even 'cure' what was initially thought to be asthma. You could try a Lung Trainer but should always check with a clinician before use.

Allergies

Inflammation can be triggered by things that you are allergic too. In some asthmatics, the temporary narrowing (constriction) of the bronchi (airways) can be triggered by cats, dogs or house dust mites. This can be seen in the nose in the way of redness and polyps; an over the counter nasal spray may help.

Fitness

Improving your general fitness level will help your asthma. There are some asthmatics that only wheeze with exercise, and only take a blue Reliever before starting to exercise. But fitness is important to your overall health.

Annual Checks
We are obliged to review your asthma at least once a year. Often, people put up with their symptoms or just put their breathlessness down to being unfit. If you are unable to book an appointment with any of our nurses, download our questionnaire and drop it by. We will not be able to do prescriptions if an annual check is not done.

All of our nurses have Asthma training and depending on whether you need a review, have a problem with one of your medications or you have just been diagnosed, our reception team can book you in with the right clinician.

As a parent, you may not like seeing your child being given an injection. But vaccination will help protect them against a range of serious and potentially fatal diseases.

There are 3 good reasons to have your child vaccinated;

• vaccinations are quick, safe and extremely effective
• once your child has been vaccinated against a disease, their body can fight it off better
• if a child's not vaccinated, they're at higher risk of catching and becoming very ill from the disease

There will always be some children who are unprotected. Maybe they cannot be vaccinated for medical reasons, they're too young to be vaccinated or very rarely, the vaccine does not work.

However, if more parents have their children vaccinated, more children in the community will be protected against an illness, such as a measles outbreak.

You may be concerned that too many vaccines at a young age could "overload" your child's immune system, but this really is not the case. Studies have shown that vaccines do not weaken a child's immune system. As soon as a baby is born, they come into contact with a huge number of different bacteria and viruses every day, and their immune system copes.

The bacteria and viruses used in vaccines are weakened or killed, and there are far fewer of them than the natural bugs that babies and children come into contact with. In fact, if a child was given 11 vaccines all at the same time, it would only use a thousandth of their immune system.

Read these articles to find out more about vaccine safety, plus the risks and benefits:

What to expect after vaccinations

Benefits & Risk of Vaccination

To check what vaccinations are needed, see the Childhood Vaccination Schedule.

Most of the food we eat is converted to Glucose (sugar) in the blood.  The body produces insulin which stores this Glucose. The amount of Glucose circulating in the blood should be kept down this way, by storing it away. Diabetes is a condition where either the body stops producing insulin (in which case, we replace it with manufactured insulin) or the body becomes resistant to the effects of the body’s own insulin (in which case we give tablets to help store the glucose away). 

Avoiding sugary foods also helps keep the Blood Glucose level down to the normal range between 4 and 7. 

If a diabetic is sick, the Blood Glucose level can rise, so it is important to keep on track with the tablets. If they aren’t eating, it is better to slightly reduce the tablets (or insulin injections, if you are on them). 

Driving the Blood Glucose level too low, by not eating enough, can cause a ‘hypo’ which can cause you to faint. In this case, a sugar cube is a useful thing to have around!

Testing the urine with Diastix is one way of measuring the Blood Glucose; the amount of sugar in the urine (brown test result) usually mirrors the level of Blood Glucose. This is suitable for most Diabetics not taking Insulin.

For those diabetics taking insulin, testing the blood by finger prick is much more accurate. Generally, a Blood Glucose of over 15 is dangerous as it should be under 7.

If you're readings are reasonably predictable, there is no need to test 2-3 times per day. You can come and show Nurse Khristyne your log book for more strips when you need them, or write them down on your repeat request.

The PCT health authority has recommended we change monitors to GlucoRx for cost effectiveness; GlucoRx strips cost £10 per box. You ought to be able to buy a meter for £15, as a one off cost to you. If you have any difficulties, the chemist or Nurse Khrystine will be able to help.

If you are diabetic and a driver, you must inform your insurance company and the DVLA.

Diet is important. Foods with high Glycaemic index (GI) release the sugar too quickly and so will drive up your blood sugar too fast. But what goes up must come down! You are then left with a blood sugar that spikes up and down all the time.

For more information on diabetes, click here.

Contraceptive Advice is available from all of the doctors as well as the local Family Planning Clinics in Sutton cased at the Jubilee Health Centre and The Rosehill Centre at St Helier Hospital. They will also be able to fit coils which we cannot currently do.

There are various methods of family planning to suit all women. Both the GP surgery and the family planning clinics are sensitive to the needs of young people, confidentiality in particular.  

Emergency contraception “morning after pill” is best taken as soon as possible after unprotected sex. This can be obtained from most chemists after a private chat with the pharmacist. In this practice, we have same day appointments available. If you are at work and cannot get here, please call to speak to a doctor on the telephone or use Online Services. Both family planning clinics have walk-in times as well, you can follow the links above.

Pregnant?

Since trying to conceive, you should be taking vitamins already such as vitamin D/folic acid, both available over the counter. You should also have discussed any repeat medications with your GP. Hopefully, you have taken advice regarding alcohol and some foods such as soft cheeses/pates and raw shellfish.

As soon as you find out you are pregnant, you should think about which hospital you wish to book at and refer yourself via their website to get the quickest appointment possible. Most of our patients choose St Helier for convenience.

With lots to think about, you may find printing My Maternity Journey booklet helpful. You can also find useful link on the NHS website.

Don't forget your Flu Jab & Whooping Cough vaccine at around 5 months; pregnant women are at high risk of Sepsis!

Unwanted Pregnancies

You will need to speak to your GP as soon as possible about an unwanted pregnancy. For more detailed information, you can visit the British Pregnancy Advisory Service.
Another useful place to find unbiased information is Marie Stopes. To self-refer to the South West London Termination of Pregnancy Services, please call 0345 872 5503.
Be aware that private companies are allowed to advertise for abortion as well.

Domestic Violence

If you are experiencing, or know someone that is a victim of domestic abuse, you can call the 24hr freephone National Domestic Violence Helpline on 0808 2000 247. They run in partnership between Women’s Aid and Refuge and answer calls 7 days a week. You can also visit www.nationaldomesticviolencehelpline.org.uk

Fertility 

How do I know if I have a problem?

Vasectomy

Please book an appointment with your GP if you would like to discuss having a vasectomy under the NHS. For information about the procedure and our current provider, please click here.

PUBLIC HEALTH ENGLAND'S Latest update

(MMR FOR ALL ADULTS) 

In England, 301 new measles infections were confirmed in the period between April and June 2019 compared to 231 in the first quarter of 2019. Cases were reported in all regions except the North East. Most cases (266) were in unvaccinated individuals aged 15 years and over.

Continuing the increase seen between January and March, 2,028 cases of mumps were also confirmed in the second quarter of 2019, compared to 795 last quarter. The increase in mumps has been mostly driven by outbreaks in university students. Cases were reported across England, predominantly in young adults aged 15 to 34 years.

Dr Mary Ramsay, Head of Immunisation at Public Health England (PHE) said:

Although it is normal to see mumps outbreaks in universities every few years, we are seeing a significant number of cases, the highest quarterly figure since 2009.

Coupled with the continued measles outbreaks these figures clearly demonstrate the need for sustained high vaccination rates.

We’re urging parents and their children, no matter how old they are, to check they’ve had 2 doses of MMR. Measles is easy to catch and can kill. Vaccines are there to stop the spread of disease and save lives.

It’s never too late to protect yourself and others.

Nearly half of the mumps cases this quarter were unvaccinated. While the mumps component of the Measles, Mumps and Rubella (MMR) vaccine is highly effective at protecting young children, immunity can reduce over time. Therefore, older teenagers and adults who received two doses of MMR in childhood can still get mumps although this is generally mild compared to those who are unvaccinated.

One new case of rubella re-infection in a pregnant woman was also reported.

CLICK HERE FOR MORE INFORMATION IN ALTERNATIVE LANGUAGES

If you require any vaccinations for foreign travel you will need to make an appointment with one of our Nurses to discuss what you may need. This cannot be done over the phone as the Nurse will need this appointment time to look up your vaccination history and the any current issues in the country you’re visiting. It is important to make this initial appointment as early as possible - at least 6 weeks before you travel - as a second appointment may be required for those vaccines which are not usually kept in stock. If needed, your second appointment will be at least 2 weeks before you travel to allow the vaccines to work.

Some travel vaccines are ordered on a private prescription and these incur a charge.  This is because not all travel vaccinations are included in the services provided by the NHS.

Yellow fever vaccination and certificates are not done here. We would advise that you contact your local pharmacy or travel clinic.

Don't forget Travel Insurance (in Europe the free European Health Insurance card will not fully cover you)

There is further information about countries and vaccinations required on the links at the bottom of the page.

Flying after an operation? Make sure you check with your GP or Surgeon any precautions you may need to take and have a look at these guidelines for an idea.

Have you checked if there are medication restrictions in the country you’re travelling to, or if you might need a letter to support having medication on board in cases like allergies or insulin? Have a look at the NHS guide and ensure you check with your airline if you aren’t sure.

The Menopause

An increasing number of ladies in their 40's and onward are suffering in silence with urinary incontinence, especially after child birth and weight increase. Don’t put up with it, book to see your GP (you can request a chaperone or female GP if you need an examination). Exercises with Aquaflex Cones can prevent as well as treat this common condition. For more information about coping with the menopause, click here and here.

Support to Stop Smoking

To obtain help with stopping smoking, including the prescribing of nicotine patches, find your nearest SmokeFree Clinic.

Cryotherapy/Wart/Minor Surgery Clinic

Appointments can be made at reception for Dr Healy after seeing a Doctor for diagnosis. The clinic treats viral warts and other minor skin lesions by using liquid nitrogen. She can treat a variety of skin lesions and cysts here at the surgery using local anaesthetic. We can also inject joints and perform surgery for ingrowing toenails. Please see a doctor if you wish to discuss these.

Immunisations

We provide all the immunisations required for residents in this country. Seasonal influenza vaccinations are given from September to December each year, and pneumonia (pneumococcal) vaccinations are given to over 65 years and other eligible at-risk groups. Teenagers are also called in for their booster immunizations. Flu Fraud Alert

Medical Examinations

For insurance, occupation or HGV/taxi purposes, by appointment with your own GP. Charges may apply, please ask reception for more details.