There are so many useful resouces on the Web today that it is really pointless for the practice to give detailed medical advice to patients within this site. We have tried to provide a number links to interesting medical web sites or contact numbers to resources for patients in our 'useful contacts' page. Please use these links for more detailed information. However, for quick reference only, these short guides might be able to answer your needs.

NB: This is not a substitute for proper medical advice and should you have any doubt you should always contact your doctor

Quick Guides

health promotion advice
coughs, colds & ‘flu
fever
cystitis
diarrhoea and vomiting
earache
burns& scalds
eyes
insect bites & stings
head injuries
headlice

Health promotion advice

There are many factors that can influence health and well being. Some of these are to varying degrees within our control and most people know them all too well but have great difficulty in making them a part of their everyday life. We cannot change our family history and we may not have the ability to change our social and economic environment but one area where people can really influence their health positively is through their own personal comittment to leading a healthy lifestyle. Keeping yourself informed to make healthy food and lifestyle choices is the only way to improve your overall health and sense of well-being.

By eating a balanced diet, taking regular exercise and not smoking you can give yourself the best chance of living a fit and healthy life.

Our doctors and practice nurses can offer further advice on health promotion but there is also plenty of help on the Web - such as this from Bandolier.

Coughs, colds & 'flu

These start with a running nose, cough, temperature, shivers and aches. They are caused by viruses and antibiotics are of no use in their treatment. The whole illness may last seven to ten days. Paracetamol, Ibuprofen or other cold/flu remedies which mostly contain paracetamol as their main ingredient and aspirin (for adults only), will help relieve symptoms.

Drink plentyof liquids. It does not matter if you do not eat for a day or two. Coughs may be helped by steam inhalation or cough linctus.

Consult the surgery if the cough persists for more than a week, if coughing produces lots of yellow or green phlegm or blood or if the cough is accompanied by pain in the chest or shortness of breath.

In the case of ‘flu-like' symptoms, consult the Doctor if there is also pain in the chest, undue drowsiness, headache, vomiting, light sensitivity or neck stiffness.

Fever

A child with a temperature, usually caused by a virus, will feel miserable, cry, may vomit, may complain of a headache or tummy ache. Bringing down the temperature as follows will make the child feel better: give paracetamol suspension (Disprol/Calpol) regularly. Strip the child to light cotton clothing or remove clothing. Put the child in empty bath and drench all over for 10 minutes with a sponge and tepid water. Give plenty to drink. Children often have a high temperature for 1 or 2 days. If you are concerned about your child, contact the Surgery for advice.

Do not put children with a high fever in a cold bath as this might precipitate a febrile convulsion.

Cystitis

Frequently passing urine, which stings or burns suggests cystitis which is often caused by infection. Drink plenty of water including bicarbonate of soda, one teaspoonful per glass of water four times daily and if symptoms persist, see the Doctor. You can also obtain a number of remedies from your local chemist. If your symtoms last more than 24 hours we strongly recommend that you seek medical advice as more serious complications can occur, especially in children. Remember to bring a fresh sample of urine in a clean container (preferably sterilised with boiling water) in case the doctor needs to test it.

Diarrhoea and vomiting

Diarrhoea is unpleasant but rarely dangerous. It may be due to viral infection, a change of diet, food poisoning or travel abroad. It is often accompanied by colicky pains and usually begins to get better in 48-72 hours. You should rest and eat nothing for 24 hours. Drink small sips of water regularly. As the stomach settles try bread or clear soup (but avoid milk, tea and coffee) before gradually returning to a normal diet. Make an appointment to see the doctor if it does not settle after 72 hours, if an attack comes shortly after a visit abroad or if there is continuous pain.

Vomiting may be caused by a viral infection of the stomach, food poisoning and by eating or drinking too much. It normally stops within 24 hours and may be followed by diarrhoea. Some children will vomit when they have a temperature. You should rest and eat nothing for 24 hours. Drink small sips of water regularly. As the stomach settles try bread or clear soup before gradually returning to a normal diet. For children and infants try dioralyte sachets made up with boiled water to replace body fluids.

Make an appointment to see the Doctor if vomiting is accompanied by continuous stomach pain, if it lasts more than 24 hours or if a vomiting child has a temperature of more than 38° C (100° F).

Earache

Earache is common in children and may be due to infection or pressure behind the eardrum caused by ‘glue ear’. It often starts at night and most commonly accompanies a cold or other upper respiratory infection. The treatment is Paracetamol every four hours. If there is accompanying fever then infection is most likely and the child should be brought to the next surgery. With ‘glue ear’ the pain is often intermittent.

Burns & scalds

Immediately run plenty of cold water over the affected part for at least ten minutes. Larger burns or areas where the skin is broken will need nursing or medical attention.

Eyes

Small pieces of grit or dirt in the eye are best washed out with plenty of water. If they persist despite this, go to Casualty. Removing any discharge with cotton wool soaked in warm water can help sticky eyes in infants. Red, inflamed or painful eyes need medical advice.

Insect bites & stings

Apply a cold compress to the site, which will help reduce discomfort. Larger swellings can be helped by antihistamine tablets available from the chemist. Piriton is well known but may cause drowsiness. Other antihistamines such as Zirtek or Neoclarityn are less likely to cause such problems.

Head injuries

If the patient wasn't ‘knocked out’ and can remember the incident, then it is unlikely that serious injury has resulted. If a baby or infant cries and objects loudly and immediately afterwards then this too is a good sign. However, if the patient was unconscious, vomiting occurs, if the patient is unduly drowsy or has double vision, he or she should be taken to Casualty immediately. If in any doubt, please contact the duty doctor.

Headlice

Headlice like nice clean hair. Having this is not a sign of being 'dirty'. Wash hair as normal and cover in a generous application of normal hair conditioner. Then comb through repeatedly with a head lice comb, which can be purchased from the chemist. The use of insecticides is no longer recomended as resistance to them is high.

Influenza

 how do I know if I have the flu?

Many people say they "have the flu" whenever they have a cold or chill, usually one that is more severe than average. Doctors and nurses only use the term for infections caused by the influenza virus. Sometimes it is very difficult to know if a severe cold is caused by the influenza virus, but it can be made easier if the patient has been in contact with other cases. Occasionally blood tests can help.

 what are the symptoms?

The major flu symptoms in adults are:

	Intense weakness and tiredness - you are likely to feel very weak and shaky even after the flu has cleared up
	Fever - often accompanied by sweating
	Joint and muscle aches and pain - especially in the back
	Cough - often accompanied by a sore throat

 so is it dangerous?

For most healthy people, the flu is a temporary (though very unpleasant) nuisance, which makes them feel awful for a week or so. However, influenza can also be a serious, sometimes fatal, illness, particularly for children under five, the elderly, or people have another long-term illness. In addition, some rare strains of influenza can even be fatal for young fit healthy adults, such as the strains that caused the major world-wide epidemics (known as pandemics) in 1918, 1957, and 1968. The influenza virus also makes sufferers more vulnerable to bacterial infections, such as pneumonia, which will need to be treated with antibiotics.

 what should I do if I catch flu?

The first thing to remember is that antibiotics will not cure influenza - they only kill bacteria and a virus, not bacteria, causes flu. The best thing to do when you have influenza is to go straight to bed and keep warm. Drink plenty of fluids and take regular paracetamol to relieve the temperature and the aches and pains (maximum two tablets four times a day for an adult; give infant paracetamol according to the age of the child - dosage on the label). Be careful not to overdose. Do not give aspirin to children under 12.

 can I do anything to avoid catching it?

Obviously, avoiding close contact with people who already have flu is a good idea. Other than that, the only preventative action that is known to work is the influenza immunisation (known as the flu jab).

 so should I have the flu jab?

Influenza immunisation is recommended for those of any age who are asthmatic, people who have diabetes, chronic (long-term) diseases affecting their chest, heart or kidneys, and those whose resistance to infection has been weakened by other disease (such as cancer or HIV infection) or treatments (such as oral steroids). It is also recommended for all those aged 65 and older, and those living in long term residential accommodation such as nursing homes, old peoples' homes, and other long-stay institutions. If none of these applies to you, then you probably don't need a flu jab. The influenza jab will not protect against all strains of influenza, because certain strains mutate frequently, so they cannot be immunised against. However, your doctor will decide whether you need the immunisation or not.

The common cold

 what causes a cold?

There are about 200 viral infections that cause a cold. Colds are spread by tiny droplets, often dispersed via sneezes and coughs, which are then breathed in by other people. The droplets can also be picked up by person-to-person contact (hands particularly), and by handling things that a person with a cold has already touched and then rubbing your nose, mouth, or eyes. Most colds occur in the winter because this is when people are most likely to be crowded together in stuffy places, and so cold viruses spread easier. There is no remedy for viral infections of any sort, including the cold virus, so there is nothing that can be taken to cure a cold.

 who gets colds?

Nearly everyone has a cold at some point. However, the younger you are they more likely you are to catch a cold because once you have had one cold virus, you are immune to it forever - there is no evidence as yet that cold viruses can mutate like flu viruses, which develop new strains that people are not immune to. Per year, school children have an average of 10 colds, a young adult about two to three, and an elderly person may have none.

 is a cold ever serious?

Colds vary in how severe they are, and people vary in how they fight off a cold, depending on how vulnerable they are. People with a low level of resistance because of a compromised immune (defence) system, perhaps because they are pregnant, weak, under stress, or already ill, are more likely to catch a cold, find it more difficult to fight off a cold once they have one, and will usually have a cold more severely than normal. In people who are extremely vulnerable, such as those with AIDS or cancer, a cold can actually be life-threatening.

 what are the symptoms?

Most colds result in a stuffy, runny nose and a sore throat. Other symptoms can include:

	Sneezing - this happens because the sensitive lining of the nose is irritated. Sneezing helps to clear the nose, but the virus is spread by air-borne droplets in the sneeze, so you should always use your hand or a handkerchief or tissue when you sneeze to avoid spreading it to other people
	Coughing - happens because the lining of the throat is irritated or, if the cold has developed into bronchitis, because of excessive mucous production inside the lungs. Like a sneeze, a cough contains air-borne droplets, so you should always put your hand or a handkerchief or tissue over your mouth when you cough
	Watering eyes - the infection can affect the eyes, causing them to produce a lot of fluid in an attempt to clear it
	Raised temperature

In addition, the infection can spread to other areas of the body, such as the lungs, resulting in bronchitis (especially common in asthmatics); the sinuses, resulting in sinusitis, or the ears, resulting in otitis media (especially common in children under the age of 10). These are known as secondary infections and can be more serious than the initial symptoms caused by the cold. They can normally be treated by your doctor.

 what can be done about a cold?

As already stated, colds are caused by viruses and so there is no known cure. However, if the cold triggers a secondary infection, such as sinusitis, then this is usually a bacterial infection, which can probably be treated using antibiotics. Things that you can do to help relieve a cold include:

	Take paracetamol if necessary - this will bring down a temperature and relieve headaches and other aches and pains. Maximum two tablets four times a day for an adult; give infant paracetamol according to the age of the child (dosage on the label), and be careful not to overdose. Do not take or give aspirin, even junior aspirin.
	Keep the air moist - a dry atmosphere can make the symptoms of a cold worse because it dries out the already sensitive and raw membranes in the nose and throat. To keep the atmosphere moist, try putting a container of water near the radiator or heater or perhaps use a humidifier.
	Drink lots and eat if you can - fluid intake is very important (water or fruit juice is best, or try soup or milkshakes), even if you have no appetite, although eating healthily will help you fight off the virus more effectively
	Moisturize the face - use petroleum jelly to help reduce a sore nose or top lip caused by too much nose blowing.
	Sleep propped up - to help you breathe more easily and can help prevent bronchitis (chest infection) developing if you are prone to it. Adults and older children can use lots of pillows, but not a young child - instead place a pillow under the head end of the cot mattress (not the child's head) or raise the head end of the cot by putting blocks under the cot legs at that end (telephone directories are ideal)

 how can I avoid catching, or spreading, colds?

You can reduce your chances of catching a cold by avoiding stuffy places wherever possible, and by avoiding direct contact with sufferers. Some people take vitamin C or eat garlic or take garlic capsules on a regular basis - both may bolster the immune system, which could help you avoid catching a cold. Keeping fit and healthy and eating a good diet will also help you stay healthy - indeed, an adult who has more than two colds a year should take steps to improve his or her overall general health, as this indicates the immune system is not working as well as it should.

Preventing the cold spreading includes not sneezing or coughing without using your hand or a handkerchief or tissue, and avoiding touching people or communal items without washing your hands first. If you have a young baby, don't let people touch your baby's hands or face, especially if they have colds. If you are unable to prevent them doing so, then wash or wet wipe your baby's hands as soon as possible.

Meningitis

 what are meningitis and meningococcal septicaemia?

Meningitis is the name given to infections and inflammations of the membranes covering the brain and spinal cord. There are different types of meningitis and, while rare, they can be dangerous - about 10% of people who get meningitis die. Meningococcal septicaemia is a type of blood poisoning caused by one of the bacteria that cause meningitis. It has similar symptoms to meningitis and, while it is even rarer than meningitis, it is very dangerous - about 50% of people who have it die. Meningitis and meningococcal septicaemia can strike at any time of life, but babies, children, and young adults are at greatest risk. Early diagnosis is essential because survival rates in life-threatening cases are much higher if diagnosed early.

 what are the signs to look for?

Some of the symptoms are common to non life-threatening cases, but a combination of several of the symptoms listed below could be serious. The two diseases can occur together, so sufferers may show symptoms of both:


Meningitis:

	Generally feeling unwell
	Stiff neck
	Unable to tolerate bright light
	Headache
	Aching limbs and joints - arms and legs feel heavy and difficult to move
	Drowsiness

Meningococcal septicaemia:

	High fever (not always obvious at first)
	Shivering, or suddenly going cold followed by shivers, cold fingers and toes
	Feeling sick, vomiting
	Severe muscle aches all over
	Losing full consciousness - drifting in and out of full consciousness, feeling very faint, or totally blacking out
	A skin rash that starts as tiny pinpricks of red and rapidly develops into large purplish blotches (i.e. in the space of a few hours or a couple of days). The rash or purple splodges on the skin will not fade away if you press them

	Tense or bulging fontanelle (that is the soft areas on a baby's head where the bone is not yet fully formed)
	Blotchy or pale skin
	Staring or glazed expression
	Refusing to feed
	Fretfulness, with a shrill or moaning cry when handled
	Stiffening body, with movements that are out of their control, or a floppy body

 what will your doctor do?

Doctors who suspect either disease will get the patient to hospital as soon as possible. They may also give an immediate injection of penicillin. Once in hospital, the patient will be given a series of tests to find out what type of meningitis bacteria has caused the disease. Antibiotic or anti-fungal treatments are the usual way of treating the diseases, and antibiotic injections are normally given automatically by the doctor before the strain has been diagnosed. Other treatments may also be needed to deal with any damage that the disease(s) may have caused.

 what can be done to prevent infection?

There are vaccines available that protect against meningitis. Make sure your children are given the meningitis C and HIB injections which are a part of the childhood vaccination schedules. Anyone who has not been vaccinated can be given a single dose meninghitis C vaccination and it is safe to give a booster if uncertain of this.

Chicken pox

 what causes chicken pox?

Chickenpox and shingles are caused by the varicella-zoster virus. Most children in the West have had chickenpox by the time they are 10 years old, so getting chickenpox when you are an adult is rare. For the vast majority of children, it is a very mild disease that lasts for about 10 days, but adults who get it can be seriously ill and may require hospital treatment. In a very few cases, adults can die from chickenpox. The chickenpox virus stays in the body's system without doing any more harm for years, but if reactivated it can trigger shingles in teenagers and adults. Chickenpox can be caught from someone with chickenpox or shingles, but shingles can't be caught from someone with chickenpox. The virus spreads by direct contact with spots, via air-borne droplets produced by uncovered sneezes and coughs, or from hand to hand contact.

 what are the symptoms of chicken pox?

	Rash usually appears two to three weeks after infection.
	Crops of small, red, itchy spots that become fluid filled in a few hours.

	Children may have a slightly raised temperature and feel tired, but otherwise feel fine apart from the itchiness.
	In adults, pneumonia, breathing difficulties, and a fever can develop.

 who is at risk from chickenpox?

Childhood chickenpox is usually nothing to worry about, and it's actually a good idea to make sure children do get it in childhood to avoid the more serious form in adulthood. For some people, however, chickenpox can be serious and should be avoided. If you have chickenpox, you should not see people in these groups until you have recovered -

	Adults who think, or are sure, they haven't had chickenpox already.
	Pregnant women in the late stages of pregnancy - babies may develop serious chickenpox shortly after birth, which can be particularly serious if the baby is born early.
	People who are being treated with immuno-suppressants, and for those who have a low immunity to disease - patients receiving chemotherapy, radiotherapy, who have just had a transplant operation, are on high doses of steroids, and who are HIV positive or have AIDS are at serious risk from chickenpox infections.

 what can be done?

Treatments will vary from person to person, depending on the type and seriousness of the infection, and your doctor will be able to work the best course of treatment for you. In all cases, you should let your doctor know if you think you may have chickenpox or shingles, particularly if you are in one of the high-risk groups. The following tips can help make the infection a bit more bearable:

	Try to avoid scratching the rash - scratching increases the chance of scarring and of other infections getting into the open spots. Keep children's nails short and their bodies covered in soft non-itchy clothing (cotton is best).
	To keep a slightly-raised temperature under control - drink plenty of fresh water, and place a clean, cool, damp cloth on the forehead. Paracetamol will also bring down a temperature, but be careful not to overdose. In adults the dose is 2 tablets every four hours or more; for children read and follow the instructions on the packaging according to age. Do not give aspirin to children under 12.
	Calamine lotion or prescribed skin treatments - can help to soothe the skin and help the spots to dry up faster.
	A cool bath, especially if containing a handful of sodium bicarbonate, may soothe the irritation.