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Thursday 29 December 2011

Lethal cashew nuts

Something as simple as two cashew nuts nearly resulted in a fatal anaphylactic reaction for a patient who walked through my door yesterday.

Although he was fine with eating peanuts and somehow managed to avoid cashew nuts all his life he made the mistake of having a a few with it being the Christmas period.

Quick thinking prevailed as he was only a few doors from the surgery and he attended with a red swollen face, swollen eyes, breathing issues and chest tightness.

High dose oxygen and 4 injections of adrenaline issued by me followed by intravenous piriton and hydrocortisone issued by the paramedic managed the situation.

So what causes these severe reactions to occur?

1) Nuts
2) Insect bites or stings
3) Medication
4) Other food or fruit


Typical symptoms are
1) Rash or hives - usually red and raised
2) Face or tongue swelling
3) Chest tightness or shortness of breath
4) Throat closing sensation

Treatment is to dial 999 for immediate help or to use an adrenaline pen if the person is carrying one or there is one available.

Tuesday 6 December 2011

Does glucosamine actually help with osteoarthritis?

Osteoarthritis, or the "wear and tear type" of arthritis as we like to call it, is very common.  It mostly affects knees, hips and hands.  The extent varies to the amount of wear and damage to the joint that has been sustained over our lifetime.

Glucosamine is often taken by patients to prevent osteoarthritis or reduce its effects and severity.
It is a natural substance that helps to build and fortify cartilage. It can also be bought as over the counter health supplements often in combination with chondroitin.

A Cochrane review of clinical studies on the effects of glucosamine show that it could help to reduce pain and improve physical function of the joint.

I certainly recommend it to my patients and the vast majority have found it to be beneficial.

Of course pain relievers are also very important for osteoarthritis pain control and can range from paracetamol to ibuprofen to codeine and stronger. Physical exercise and keeping active prevents stiffening of joints with time.

Physiotherapy and steroid joint injections also have a role to play.

Monday 5 December 2011

Migraines

A problem for many. Ranging from mild to very severe. Some people have:
- the headache and flashing lights and nausea
- no headaches but flashing lights/nausea
- severe headache only
- tingling or weakness - could also be a sign of a more serious stroke type event

If migraines are diagnosed by the doctor it is important to look for triggers as these will often be present.
Triggers include caffeine, stress, certain food products and smells.

Treatment includes rest and pain killers (paracetamol or ibuprofen or codeine - can be bought over the counter) or stronger medication such as migraleve or sumatriptan. It is usually best to target the pain as soon as the attack starts and anti sickness medication may also be needed.

Prevention is often dealing with the triggers and root cause for the attacks.

Medication such as propranolol or pizotifen can also reduce the frequency of attacks but need review by the doctor and prescribing.

An eye sight test is also important to check for any illness in the eye and eye strain. Opticians do a very a good assessment as part of a routine eye check.

Sunday 4 December 2011

Gum disease

Increasingly common and mostly linked to our dietary habits.

Soreness and bleeding gums are the most common signs.  Tooth decay often follows suits or is co-existing.

Simple remedies I recommend are:
1) plenty of vitamin C - citric fruit and/or squash etc. apply a dose of vitamin C direct to your gums and cleanse the mouth too
2) mouthwashes - get to the areas where toothbrushes cannot reach
3) a good toothbrush that is not harsh to your gums but effective - electric ones seem to be more help than manual nowadays
4) anti-inflammatories if particularly inflamed and sore gums

Friday 2 December 2011

Lethargy

More often than not it is the stresses and strains of modern living and poor sleep that cause tiredness and fatigue.

However it is important to exclude other causes including:
1) anaemia
2) malnourishment
3) thyroid problems
4) diabetes
5) calcium disorders
6) depression
and others.

Blood tests often rule most of these out but a close review of our lifestyle and simple changes to ensure we exercise regularly and eat healthy can also make a difference.

Thursday 1 December 2011

Internet feeding anxiety?

For those people of an anxious disposition the advent and uptake of the internet and websites that provide information on everything under the sun can often lead to increased anxiety for the reader.

Searching for medical information has become a lot easier and the accuracy of information on certain websites leaves a lot to be desired.  Technical terms and jargon lead to greater confusion for the reader too.

It is always best to ask a health professional for advice rather than research too deeply into medical conditions or drugs online as medical practice is very different from one country to the next and most treatments need signifcant evidence behind them to be taken as being effective.