Blog

My Health

Asthma

airway

Asthma is a common condition that affects the airways. The typical symptoms are wheeze, cough, chest tightness, and shortness of breath. Symptoms can range from mild to severe. Treatment usually works well to ease and prevent symptoms. Treatment is usually with inhalers. A typical person with asthma may take a preventer inhaler every day (to prevent symptoms developing), and use a reliever inhaler as and when required (if symptoms flare up).

HOW TO USE AN INHALER.

If you would like to see a video on how to use an inhaler, please click on this link. 

Asthma – Condition Leaflet
This leaflet gives an outline of asthma
Click Here – Asthma
Asthma – Peak Flow Meter
This leaflet outlines how you can monitor you asthma with a peak flow meter
Click Here – Asthma – Peak Flow Meter

Asthma App

We recommend this app. My Asthma Log as an Android App to give children, young people and parents another user friendly format of this individualised asthma management tool.

 

My Goals

Walking Is Best Medicine

This is a really useful video which outlines the health benefits of going for regular walks.

Hounslow Health Activities

Here is a document which outlines health walks organised by London Borough Of Hounslow.

Click here to download
Local Activities – All are free of charge

Advice On Stopping Smoking

Here is a helpful video which you may want to watch to begin your journey to stop smoking.

Hounslow Smoking Cessation Clinics

Here is advice on local stop smoking clinics. We also run clinics in the practice. Please book an appointment for our healthcare assistant.

Smoke Free Leaflet
Click here to download Leaflet smokefree_leaflet

Healthy Eating

Lots of helpful information on healthy eating may be found on this website link. Click Here.

Eat Well Plate
This shows the proportions of food groups for a balanced healthy diet.
Click here to download information –Eatwellplate

My Carer

Carers

CARER SUPPORT SERVICES

 Friends or relatives that care for a patient with a long term condition or disability are the unsung heros of the health service. This can have be lonely and have a detrimental impact on the carers health. It is important that you are aware that you are eligible for. Our practice is committed to identify and refer carers to the support organissations that are available. We have listed some below.

 

As part of the Local Authority and CCG’s continuing drive to support Carers (unpaid residents caring for someone with either a disability, illness or addiction to alcohol or drugs, the following  support services have been commissioned from April 2013.

 

  • Carers Rights, Information and Advocacy:  to provide advice, information and advocacy in the following areas: Welfare Rights, Housing Advice (including rent arrears, homelessness, repairs, possession proceedings and tenancy issues) and employment.  This service is provided by Crossroads Care West London.

Contact details: Tel: 020 8570 6963

  • Outreach Support service (for Carers of services users with Long term Conditions including dementia): specialist ongoing support service to carers in Hounslow who look after someone with a disability. This service is provided by INS (Integrated Neurological Services) in partnership with The Alzheimer’s Society, Ealing Mencap and Richmond Aid.

Contact details: Tel: 020 8755 4000 or email: admin@ins.org.uk

  • Peer Support and Training: will provide training to support Carers in their roles.  It will also provide peer support groups.  This service is provided by INS (Integrated Neurological Services).

Contact details: Tel: 020 8755 4000 or email: admin@ins.org.uk

  • Short Breaks:  will provide short breaks to Carers from their caring role both in their homes and through community based activities.  This service is provided by Crossroads Care West London and The Alzheimer’s Society.

Contact details:

Crossroads Care West London: 020 8728 7000 or e-mailealing.info@crossroadscarewestlondon- break services based in the Carer’s home.

The Alzheimer’s Society: 020 8580 1057 or e-mail: hounslow@alzheimers.org.uk- Community based short break services.

Support is also available to Carers from the Local Authority. Examples of this support include

  • Carer vouchers and direct payments which eligible Carers can use to purchase support services to make their lives easier.
  • Carers emergency card: in the event that the Carer has an accident or is temporarily unable to care, an agreed plan is put into action

For further information, contact the Adult Access Team on 020 8583 3100; e-mail: Adultsocialcare@hounslow.gov.uk

Crossroads

Crossroads – Children’s Services Brochure
Crossroads – Adult’s Services Brochure
Crossroads Self Referral Form
You can refer yourself to Crossroads, using this form.
Click here for Self Referral Form Crossroads Referral form

Carers Self Referral Form

Carers Self Referral Form
Advice and support is available for you, if you care for someone with a long term condition or disability who has care needs. You may complete this form for an assessment to be carried out.

My News

‘Safer IVF’ with kisspeptin hormone shows promise

Baby HeathBaby Heath was one of the babies born in the trial, pictured at two months old

Related Stories

Twelve babies have been born using a potentially safer way of getting eggs for use in IVF, UK doctors say.

The naturally occurring hormone, kisspeptin, was used to stimulate women’s ovaries to produce eggs.

The pregnancies, reported in the Journal of Clinical Investigation, show the hormone can be used successfully.

Fertility researchers hope kisspeptin will prevent ovarian hyperstimulation syndrome (OHSS), but larger trials are needed to fully assess safety.

A hormone, hCG, is normally used to produce a few eggs for IVF.

But in around 10% of patients, the ovaries go into overdrive and produce too many. The condition can lead to kidney failure and potentially death.

‘Triumphant moment’

Embryo selection for IVF

In 2003, UK researchers discovered kisspeptin. It is heavily involved in the menstrual cycle and people without the hormone will not go through puberty.

The team at Imperial College London believe kisspepin would stimulate the ovaries in a gentler, more natural way that would prevent OHSS.

The first human trials have been taking place on 53 volunteer couples at Hammersmith Hospital in London.

Eggs were successfully collected from 51 women, of whom 12 have since given birth.

Prof Waljit Dhillo, of Imperial College London, told the BBC: “The first patient who went though the study got pregnant. It was the best outcome you could have wanted, it was a really triumphant moment.

“We think it should be safer. We’ve now shown it is effective, but we need larger studies.”

The next trials will take place in women with polycystic ovary syndrome, who are more vulnerable to overstimulation.

If they are successful, a further series of trials will be needed to compare the success rates of kisspeptin and conventional therapy.

Owen HeathOwen Harper was another child born on the trial

Alison and Richard Harper gave birth to baby Owen in October 2013.

Alison said: “I went through several cycles of IVF previously but the one in the trial was the least uncomfortable. It was less painful and I felt less swollen.”

Prof David Adamson, of the International Federation of Fertility Societies, said: “This is an interesting study that identifies an additional new drug that could potentially make IVF, an already safe procedure, even safer.

“Other effective strategies to prevent OHSS are already in clinical practice, and the new drug would have to go through large clinical trials to confirm its efficacy, safety and equivalence to these other medications currently in use.”

Dr Yakoub Khalaf, the director of the assisted conception unit at King’s College London, said: “This is an interesting study.

“Whilst it is plausible that the risk of hyperstimulation syndrome could be reduced following use of kisspeptin, the number of patients studied is too small to demonstrate reduction in the incidence.

“The bottom line is an interesting product but more clinical data is needed to demonstrate that kisspeptin is not just safe but also does not reduce the chance of a pregnancy.”

What to do if you feel unwell this Christmas

We wish you a safe, healthy and happy Christmas break this year!

christmas-openii

We are pleased to share that our practice will be open from 0800-2000 every day, including Christmas Day, Boxing Day and New Years’ day. You can access appointments by calling 111 who can also give you advice if you feel unwell. There is map of how to get to the practice below, however public transport may be limited over the holiday period.

Map - Firstcareii

Choose the right place for help that you may need this winter. 

If you have a mental health problem, you can call 030 0123 4244. This line is open for advice and links to mental health services 24 hours a day.

nhs-services1.jpg

Online resources

There is also a lot of great health information on the NHS website 

If you have a minor ailment – eg. cough, sore throat, back pain – there is a lot that you can do for yourself. This website is a good resource for information Self Care

Local Pharmacies

There are pharmacies that are open during the bank holiday period at different times. They can offer you medical advice and medication. Here is a list for Hounslow.

Screenshot 2017-12-25 09.29.23

Accident & Emergency

In a life-threatening emergency Always call 999 if someone is seriously ill or injured, and their life is at risk.

Examples of medical emergencies include (but are not limited to):

  • chest pain
  • difficulty in breathing
  • unconsciousness
  • severe loss of blood
  • severe burns or scalds
  • choking
  • fitting or concussion
  • drowning
  • severe allergic reactions.

 

 

Housing Letters

If you are making a housing application, you do not need delay your application or incur charges by requesting a housing letter from the practice. Any medical assessment can be done by the the Hounslow Council. You are request this online. If you need to access your medical records, please contact reception with your ID and can activate it for you.

If you would like to download the letter, please click on the link here.

PATIENT REQUEST TO GP FOR LETTERS IN SUPPORT OF HOUSING APPLICATION – PDF[1]

Screen Shot 2017-12-12 at 12.55.12.png

Medication Alert – BUCCOLAM 2.5 mg, 5 mg, 7.5 mg and 10 mg Oromuscosal Solution Pre-filled Syringes

Screen Shot 2017-12-07 at 15.52.14BUCCOLAM 2.5 mg, 5 mg, 7.5 mg and 10 mg Oromuscosal Solution Pre-filled Syringes

  •   Shire has distributed the Direct Healthcare Professional Communication (DHCP) attached due to reports that the translucent tip-cap sometimes remains on the syringe tip when pulling the red cap off, as shown in the DHCP diagrams.
  •   If this occurs, the translucent tip cap needs to be removed manually to enable administration of BUCCOLAM and to prevent it falling into the patient’s mouth upon application of extreme pressure. There have not yet been any reports of the translucent tip-cap falling into a patient’s mouth but this cannot theoretically be excluded.
  •   This issue is applicable to all unexpired batches of BUCCOLAM currently in the marketplace.

This is a good time to share how to use the use buccal mizolam – from Great Ormand Street. 

Buccal (oromucosal) midazolam

Buccal midazolam is a drug used to stop seizures.

What is midazolam?

Midazolam belongs to a group of medicines called benzodiazepines, which are used to treat a number of different conditions, including seizures. If a seizure lasts for more than five minutes, it may be difficult to stop unless treatment is given. It is therefore important that rapid treatment is given to stop the seizures and therefore prevent status epilecticus. Status epilepticus is a condition where a person has a seizure (convulsion or fit) or a series of seizures that last for 30 minutes or more, without a complete recovery of consciousness.

Midazolam is chemically related to diazepam, which is another medicine used to treat seizures.

How is buccal midazolam given?

The midazolam solution should be placed against the sides of the gums and cheek so that the medicine is absorbed directly into the bloodstream. This is known as the buccal or oromucosal route. If the medicine is swallowed accidentally, it might not work as quickly.

Buccal midazolam is available as:

  • Buccolam® contains Midazolam Hydrochloride 5mg in 1ml in pre-filled oral syringes of 2.5mg, 5mg, 7.5mg and 10mg.
  • Epistatus® contains Midazolam Maleate 10mg in 1ml. It is a preparation in a 5ml bottle with four oral syringes in the packaging. Epistatus® is also available as pre-filled oral syringes of 2.5mg, 5mg, 7.5mg and 10mg. This is an unlicensed product, available as a ‘special’.

It is important to remember which brand and dose your child uses.

Instructions for giving buccal midazolam

  • Your local medical team will train you how to prepare and give buccal midazolam.
  • Always check the dose and expiry date before use.
  • Give the medicine slowly to stop your child swallowing the medicine as this may cause them to choke.
  • If buccal midazolam does not control the seizure within five minutes, follow the advice given by your doctor or call 999 for an ambulance.
  • If you cannot give buccal midazolam for any reason, give first aid and call 999 for an ambulance.

Using Buccolam® pre-filled oral syringes or Epistatus® pre-filled oral syringes

  • Check the dose and expiry date of the pre-filled syringe provided.
  • Remove the oral syringe from the packaging.
  • Place the syringe into the side of your child’s mouth, between the gums and teeth.
  • If possible, divide the dose so you give half into one cheek and the remaining half into the other cheek.
  • Slowly push the plunger of the syringe down until the syringe is empty.
  • Watch for any breathing difficulties.
  • Confirm that the seizure has stopped.
  • Dispose of the syringe safely.

Using Epistatus® buccal liquid (Midazolam Maleate 10mg/1ml) 5ml bottle

  • You will need the following equipment:
    • bottle of Epistatus®
    • oral syringe provided
  • Check that the liquid is clear with no crystals visible. Discard if you can see crystals.
  • Unscrew the bottle cap, keeping the bottle upright.
  • Insert a syringe into the centre of the stopper.
  • Turn the bottle upside down.
  • Pull the plunger of the syringe back slowly and then push back to prevent any air bubbles.
  • Pull the plunger back again slowly and draw up the prescribed amount of liquid.
  • Turn the bottle the right way up before removing the syringe.
  • Put the cap back on the bottle to stop spillages.
  • Place the syringe into the side of your child’s mouth, between the gums and teeth.
  • If possible, divide the dose so give half into one cheek and the remaining half into the other cheek.
  • Slowly push the plunger of the syringe down until the syringe is empty.
  • Watch for any breathing difficulties.
  • Confirm that the seizure has stopped.
  • Dispose of the syringe safely.

What are the side effects of buccal midazolam?

  • Drowsiness and sedation – recovery is usually fast.
  • Amnesia or short-term memory loss – your child may not remember having had a seizure.
  • Breathing difficulties – your child is unlikely to have breathing difficulties if midazolam is given at the correct dosage. If breathing difficulties do develop, seek medical assistance.
  • Restlessness, agitation and disorientation – these can occur but are usually rare.

Important information about buccal midazolam

Give the medicine as prescribed by your doctor.

  • If your child stops using midazolam or it passes its expiry date, please return it to your pharmacist. Do not flush it down the toilet or throw it away.
  • Keep midazolam in a safe place where children cannot see it or reach it.
  • Keep midazolam at room temperature (not in a fridge), away from bright light or direct sunlight and away from heat.
  • Always check you have enough medicine and remember to order a new prescription in plenty of time.

9 ways to prevent dementia

One in three cases of dementia could be potentially prevented by targeting nine risk factors, including continuing education in early life, reducing hearing loss in mid-life, and stopping or reducing smoking. Such prevention requires public health interventions, as well as individual action. Acting now will vastly improve life for people with dementia and their families, and in doing so, will transform the future of society.

KEY MESSAGES

• Dementia is the greatest global challenge for health and social care in the 21st century

• The number of people with dementia is increasing globally

• Prevention is possible and rates of dementia can be greatly decreased

• 9 lifestyle risk factors account for 35% of the risk of getting dementia

• While genes affect Alzheimer’s disease they are relatively less important in older people. The only important gene APOE4 accounts for 7% of risk

• Ambitious action is required at both a policy and

societal level to implement preventative strategies

NINE PREVENTABLE RISK FACTORS

• stopping education at the age of 12-15 years old

• high blood pressure

• obesity

• hearing loss in mid-life (45-65 years old)

• smoking

• depression

• physical inactivity

• social isolation

• diabetes in later life (over 65 years old)

You can download the report here

Preventing Dementia – 9 key risk factors[1]

Prevention & early signs of dementia

Here is some advice from Bilal Dunoo, who presented at our dementia event recently.

Prevention / Early signs / Services available

Dementia encompasses a range of Brain disorders characterised by a gradual decline of the brain functions, it is incurable and slowly interferes with person’s ability to carry out normal tasks of daily living. I am referring to wider mental abilities that we require to execute tasks pertinent to living independently. With age, you may noticed changes in your thinking abilities, such as how easily you can focus your attention, how well you remember new information, or how quickly you come up with words in conversation. These changes are associated with ageing but if you observe a rapid decline say over a period of 6 months and it is affecting your daily life you must seek help because one of the early symptoms of dementia is difficulty in remembering recent events. As the disorder develops, a wide range of symptoms can emerge, such as disorientation, mood swings, confusion, more serious memory loss, behavioural changes, difficulties in speaking and swallowing, and problems with walking.

Dementia has an enormous impact on the lives of individuals and their families/carers. In fact, Brain disorders are particularly debilitating or brutal. Whether they arrive with life-wrecking abruptness, or in the slower form of Brain disorders like dementia. They destroy a person’s human nature while he or she is still alive. Motor neuron disease takes away our most basic freedom: physical movement. Stroke can paralyse, bring depression and listlessness, or cut off communication altogether. Some kinds of dementia can turn a spouse into a stranger – before they eat away the self completely.

The prospect of decline in chronic and progressive brain conditions is a grim one, and fluctuations in the conditions can make daily life extremely frustrating. Family members/carers for a patient living with dementia need support too, with research showing that carers of people with dementia experience more physical and mental ill health than do other carers.

The management of dementia is like that of any long-term condition but it is particularly helpful to have a structured approach. Early diagnosis and any clinical/psychological intervention are important. They give an opportunity for patients and family members/carers to receive essential information and plan for their future, while patients are able to make their wishes known and make arrangements for a time when they may have impaired decision-making capacity, for example financial management, wills, advance directives.

  • Many modifiable risk factors – including high blood pressure, obesity, physical inactivity, and unhealthy diet – are shared among dementias, including Alzheimer ’s disease, and other major late-life chronic disorders, such as heart disease and stroke.
  • Recommended diet – vegetables, beans and pluses, wholegrains and fish with moderate consumption of dairy products (as cheese and yoghurt) and low consumption of meat products. Reduce salts, fats and sugars.
  • In later life exercise brings physiological and psychological benefits, reducing illness, improving functional ability and improving well-being. Encouraging older adults to become more active and maintain that activity is critical to the promotion of their health and well-being, maintenance of social networks and independence.
  • Ensure you adopt a regular and an undisturbed sleep patterns.

List of the essential Dementia Services in Hounslow

Cognitive Impairment and Dementia Service – CIDS Tel: 0208 483 1800

Admiral Nurse Dementia Helpline Tel: 0800 888 6678 Email: helpline@dementiauk.org

Alzheimer’s Society Hounslow  Tel: 0208 580 1057 Email: hounslow@alzheimers.org.uk (Free short-breaks, Singing for the Brain and Dementia Advisor).

Dementia Adaptation Grant  Tel: 0208 583 3877/3852/4321  Email: housingadaptationservice@Hounslow.gov.uk

(Minor adaptation to make your home dementia friendly).

First Contact Team (Adult Social Care) Tel: 0208 583 3100 Email: adultsocialcare@hounslow.gov.uk

Handy Person  Tel: 0208 583 3878 Email: homeimprovements@Hounslow.gov.uk (Offers practical DIY service around you home environment).

Supporting Independence Service Tel: 0208 583 3942 Email: supporting.independence@Hounslow.gov.uk

Utility bills, rent arrears, accessing welfare benefits or any other relevant services that you may require in order to remain independent in your home.

LinkLine Tel: 0208 583 4400 Email: Linkline@hounslow.gov.uk (Telecare equipment to improve your safety in your home).

References:

Matthew P, Pase, et al., (2017) Sleep architecture and the risk of incident of dementia in the community. Journal of the American Academy of Neurology. 89(12) 1244-1250.

Pace. Victor, Treloar. Adrian & Scott. Sharon (2011) From advanced disease to bereavement. Oxford. OUP.

The Lancet Neurology Commission (2016) Defeating Alzheimer’s disease and other dementias: a priority for European science and society. The Lancet Neurology, Vol. 15, No. 5, p455–532.