Newsletter "Your Health"
- Checkups can keep you healthy
- Asthma control. What’s your score?
- Don’t panic. Help is here.
- Contraceptive ring now available
- Coeliac disease. Could you have it?
- Can I get rebates for visits to a psychologist?
- How long are specialist referrals valid?
- Using ‘ice’ is not cool
- Conjunctivitis. A sticky problem.
- How to lose weight (Joke)
Many people only go to their doctor when they feel sick. However, by having regular checkups when you are well, your family doctor can work with you to help you stay as healthy as possible.
Many illnesses can be prevented by regular checks. For example, bowel cancer screening can detect a benign polyp that can be removed before it turns cancerous. Other diseases found in the early stages, such as a small breast cancer detected on a mammogram, have a greater chance of cure.
A preventative health checklist
The Royal Australian College of General Practitioners recommends the following checks, starting with these (SNAP) lifestyle habits:
- Smoking. How many cigarettes are you smoking a day?
- Nutrition. How many portions of fruit and vegetables do you eat each day?
- Alcohol. Are you sticking to safe drinking guidelines?
- Physical exercise. Are you getting 30 minutes moderate activity most days?
Now tick this list and show your GP:
- Blood pressure. Checking advised for all adults from age 18 at least 2-yearly.
- Cholesterol. Testing recommended at least every 5 years from age 45.
- Immunisation. A tetanus-diphtheria shot is given at age 50. From age 65, influenza vaccine is advised annually and pneumonia shots every 5 years.
- Bowel cancer. Regular screening from age 50 is now routine.
- Diabetes. Especially if you are >55, overweight or have a family history.
- Weight. 67% of men and 52% of women are overweight or obese.
- Skin cancer. Do you have fair skin or a spot or mole that has changed?
- Pap tests. Women aged 18-70, 2-yearly.
- Breast cancer. Mammograms every 2 years from age 40 save lives.
- Sexual health. Are you practising safe sex? Could you have caught a sexually transmitted infection?
- Osteoporosis. Women from 45 years and men from 50 should be assessed.
- Prostate cancer. Men from age 50.
Other checks for people at high risk of stroke, kidney disease and glaucoma may be advised by your GP.
The ‘45 year health check’
A new health check has recently been introduced by Medicare for people from 45-49 years of age (inclusive) who are at risk of chronic disease. It aims to identify health problems in the early stages in order to prevent or delay disease. Ask your GP about this service.
Asthma control. What’s your score?
Asthma Score is a simple new test people over 14 years can use to measure their asthma control, just like people with diabetes measure their blood glucose.
The majority of people with asthma are not as well controlled as they should be. Check your Asthma Score regularly (weekly or monthly) and show the results to your GP.
Asthma treatments include relievers (blue puffers) and preventers. Preventers usually contain an inhaled corticosteroid that treats the underlying inflammation in the airways and should be used every day, even when you are well, to keep your airways healthy. Your doctor will decide what treatment you may need.
Asthma Score is endorsed by the National Asthma Council and the Asthma Foundations of Australia. www.asthmascore.com.au or www.nationalasthma.org.au for more info.
ASTHMA SCORE |
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Q 1. In the past 4 weeks, how often did your asthma prevent you getting as much done at work, school or home? |
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(1) All the time |
(2) Most of the time |
(3) Some of the time |
(4) A little of the time |
(5) Not at all |
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Q 2. During the past 4 weeks, how often have you had shortness of breath? |
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(1) More than once a day |
(2) Once a day |
(3) 3-6 times a week |
(4) Once or twice a week |
(5) Not at all |
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Q 3. During the past 4 weeks, how often did your asthma symptoms (wheezing, coughing, shortness of breath, chest tightness or pain) wake you up at night or earlier than usual in the morning? |
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(1) 4 or more times a week |
(2) 2-3 nights a week |
(3) 1 night a week |
(4) <1 night a week |
(5) Not at all |
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Q 4. During the past 4 weeks, how often have you used your blue puffer or reliever medication? |
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(1) 3 or more times a day |
(2) 1-2 times a day |
(3) 2-3 times a week |
(4) Once a week or less |
(5) Not at all |
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Q 5. How would you rate your asthma control during the past 4 weeks? (How well controlled is it?) |
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(1) Not controlled at all |
(2) Poorly controlled |
(3) Somewhat controlled |
(4) Well controlled |
(5) Fully controlled |
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score: 25 total control; 20-24 may be well controlled but not totally controlled; <20 may be poorly controlled. |
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Metric Incorporated 2002, 2004. All rights reserved. Asthma Control TestTM is a trademark of QualityMetric Incorporated and is distributed by GlaxoSmithKline Australia Pty Ltd, 1061 Mountain Hwy, Boronia, VIC 3155. ABN 47100162481.
Panic disorder is a terrifying condition. Sufferers have sudden and repeated episodes of intense fear and anxiety (panic attacks) for no apparent reason.
Attacks are accompanied by physical symptoms such as a pounding heart, sweating, weakness, chest pain, hot flushes, shortness of breath and dizziness.
Although the attacks are simply due to anxiety, people having panic attacks believe they are about to lose control, have a heart attack, die or go crazy. Many develop intense anxiety between attacks, worrying when and where the next one will occur.
Panic disorder typically begins between the ages of 20 and 40 years. The condition is often inherited and is more common in people who are already anxious.
Effective treatment is available
Firstly, see your GP for a check-up to rule out any underlying physical cause. Many people find relaxation strategies, regular exercise and avoiding caffeine helpful. Slow breathing techniques or breathing into a paper bag can ease the symptoms.
Two effective treatments are available and work best when used together:
- Cognitive Behaviour Therapy (CBT) is a type of counselling which helps you identify and challenge the anxious and unrealistic thoughts you have when you panic. CBT helps you understand that your symptoms are not harmful and teaches you to overcome your fear of panicking in certain situations.
- A number of antidepressants are commonly used to relieve the symptoms of panic disorder, even in people who do not have depression. These medications are effective and generally well tolerated but can cause side effects. They are not addictive.Ask your GP for help.
Contraceptive ring now available
A new vaginal contraceptive ring is now available in Australia on prescription from your doctor.
The device is a soft, plastic ring, 55mm wide, which is inserted in the vagina each month like a tampon. It is worn for 3 weeks and then removed for 1 week, during which time the period occurs. The ring can also be replaced after 3 weeks to skip a period.
The ring releases oestrogen and progestogen like the contraceptive pill but in lower doses. The hormones are absorbed into the bloodstream through the vaginal wall and work mainly by preventing the release of eggs from the ovary.
Effective and well tolerated
The contraceptive ring is as effective as the Pill. With correct use, it is about 99% effective and starts to work within about 7 days.
Most women cannot feel the ring when it is in place and most of their partners are not aware of it during intercourse.
The contraceptive ring can cause similar side effects to the Pill such as vaginal discharge, nausea, acne and headache. It does not usually cause weight gain. As with the Pill, there is a slight increase in the risk of blood clots, heart attack and stroke.
The vagina holds the ring securely in place and expulsion is rare. It is usually due to not placing the ring high enough initially.
The ring provides very good control of the menstrual cycle and spotting is uncommon. Bleeding is usually lighter and shorter.
The ring is not suitable for women who are unable to use the Pill for medical reasons, such as a past blood clot or smokers over 35 years. However, it is an alternative for women who dislike taking a daily pill or for those who forget to take them regularly.
Coeliac disease. Could you have it?
Coeliac disease is a common bowel condition with serious complications if untreated. Unfortunately, the great majority of affected adults are undiagnosed.
In coeliac disease, the cells lining the small bowel become damaged when exposed to gluten, a protein found in wheat, barley, rye and possibly oats. This can lead to symptoms such as diarrhoea, bloating, wind, loss of weight and chronic tiredness.
Coeliac disease interferes with the absorption of important nutrients such as folic acid, iron, calcium and vitamin B12, which can lead to anaemia or osteoporosis. It can also cause mouth ulcers, repeated miscarriages, infertility and certain cancers.
Who should be tested?
- People with the above symptoms or medical conditions.
- Those with a close family member with the disease, as it often runs in families.
- People with type 1 diabetes, Down’s syndrome and some thyroid and liver disorders, as they have increased risk.
Initial testing is with a simple blood test by your GP. If this is positive, a biopsy of the small bowel is performed by passing an instrument from the mouth to the upper bowel under a light anaesthetic (endoscopy).
Treatment of coeliac disease
Coeliac disease is treated by a strict, lifelong gluten-free diet. Consulting a dietitian is recommended for advice on how to select gluten-free foods and read food labels.
Gluten is found in breads, cakes, biscuits, pastas, cereals, beer and many commercial foods. Many gluten-free and low-gluten products are now available.
Contact the Coeliac Society at www.coeliac.org.au or visit www.gesa.org.au.
Can I get rebates for visits to a psychologist?
Yes. Since 1 November 2006, eligible patients can now claim substantial Medicare rebates for counselling from a psychologist (or social worker or occupational therapist) for mental health conditions such as anxiety, depression, panic disorder and phobias.
Your GP first needs to prepare a GP Mental Health Care Plan. This involves assessing your problem and developing goals and a treatment plan. If a referral is appropriate, you can claim rebates for up to 12 sessions per calendar year.
How long are specialist referrals valid?
Referrals to medical specialists (such as gynaecologists and orthopaedic surgeons) are required in order to claim full Medicare benefits for a consultation. Referrals from your GP generally last 12 months.
Ongoing referrals for a particular condition are also sometimes issued where long term care of that condition is needed.
It is a good idea to check that your referral is still valid before you see your specialist. It is illegal for your GP to give you a backdated referral after the consultation.
In recent years, there has been a dramatic rise in the use of ‘ice’ or crystal methamphetamine among young people. Ice is a dangerous and addictive drug with many harmful effects.
What exactly is ice?
Ice is a highly purified form of methamphetamine (‘speed’) which looks like small fragments of broken glass. It is a very powerful stimulant which is usually smoked in a glass pipe, injected into the veins, swallowed or snorted (sniffed).
Users get a sense of euphoria and well-being. Ice also boosts confidence, energy levels, alertness and motivation.
What are the side effects?
Because of its high potency, the unwanted effects of ice are more severe than for speed. They include anxiety, loss of appetite, rapid talking, shaking hands and insomnia. Serious effects include:
- Aggressive and violent behaviour.
- Psychosis, with hallucinations (hearing and seeing things which aren’t there), paranoia and weird thoughts.
- Raised blood pressure, heart attacks, strokes and coma.
- Complications of unsafe sex and injecting practices, such as pregnancy, HIV.
What happens when you stop ice?
The worst part of using ice for most people is ‘coming down’. Anxiety, depression, mood swings and fatigue are common withdrawal effects and can last 2-3 days.
Complete withdrawal can take several weeks. During this time users may experience disturbed sleep, mood swings, poor concentration and strange thoughts. Strong urges to use the drug again (cravings) can be difficult to resist.
Ice is a highly addictive substance and users may need professional help during withdrawal – ask your GP or visit the National Drug and Alcohol Research Centre at http://ndarc.med.unsw.edu.au and download a copy of ‘On Thin Ice - A Users Guide’.
Conjunctivitis. A sticky problem.
Conjunctivitis is a common eye infection in young children. It is not normally a serious condition and most cases get better without treatment.
Conjunctivitis is an infection with a bacterium or virus of the ‘conjunctiva’, the clear lining over the eyeball and inside the eyelids. Symptoms include:
- Redness in the whites of the eyes.
- Irritation or a gritty feeling.
- A watery or sticky discharge. The eyelids often stick together on waking.
- Swelling of the eyelids.
- Sensitivity to light.
Bacterial conjunctivitis usually produces a sticky discharge whereas viral infections cause watering or tearing.
Conjunctivitis sometimes develops as part of a head cold. It is spread by contact with discharge from the eyes, from contaminated fingers or objects such as handkerchiefs or by coughing and sneezing.
Treatment for conjunctivitis
Most cases of bacterial conjunctivitis get better without medical treatment within 5 days. Simply bathe the eye several times a day to remove the pus.
For more severe or persistent cases your GP may prescribe antibacterial eye drops or ointment which should be used until several days after symptoms settle.
Viral conjunctivitis usually resolves within 2-3 weeks without any treatment.
Conjunctivitis is very contagious. Always wash your hands after touching your child’s eyes to avoid catching it yourself. Children should not return to school or child care until the discharge has gone.
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Other serious eye conditions can mimic conjunctivitis. See your doctor if you are worried or if there is severe pain, a change in eyesight or sensitivity to light.
A woman is terribly overweight, so her doctor puts her on a diet.
“I want you to eat regularly for two days, then skip a day, and repeat this procedure for two weeks.”
When the woman returns, she’s lost nearly 10 kilograms. “Why, that’s amazing!” the doctor says. “Did you follow my instructions?”
The woman nods. “I’ll tell you though, I thought I was going to drop dead that third day.”
“From hunger, you mean?” asked the doctor.
“No, from skipping,” she replied.
