Newsletter "Your Health"
- Heartburn. The good news.
- Diabetes? The hype on hypos
- Your health online
- Which contraceptive is best for you?
- Time to come clean at home
- Can pregnant women have flu injections?
- What is the deadline for FREE HPV vaccine?
- Give your child a cool lunch box!
- When are child headaches serious?
- ‘No added fat’ beef & mushroom stir fry
Heartburn. The good news.
Potent treatment for heartburn is now available over-the-counter (OTC). This is good news for many sufferers who are getting inadequate relief from their current OTC medication.
Heartburn occurs when acid from the stomach escapes into the oesophagus (reflux). This causes a burning feeling rising from the stomach or lower chest towards the neck. Regurgitation of acid into the mouth can cause a sour or bitter taste.
Lifestyle changes such as avoidance of trigger foods (e.g. fatty or acidic foods), weight loss, reducing alcohol intake, quitting smoking and avoiding lying down for 2-3 hours after eating, may help to prevent episodes.
Some people may also need long termdaily medication for complete control of symptoms. For others, it may be sufficient just to treat flareups as they occur.
How to treat flareups
OTC medications can give quick relief for mild or occasional symptoms. Antacids neutralise the acid in the stomach and medications such as ranitidine and cimetidine reduce acid production.
PPIs (proton pump inhibitors) lower acid production more effectively. They give the greatest symptom relief but take longer to work than antacids. They are available on script for more severe cases.
Pantoprazole is the first PPI to be available in a lower dose without a prescription. It is suitable for people who have troublesome episodes of heartburn 2 or more days per week. Pantoprazole is taken once daily for 7-14 days. Sideeffects are uncommon and can include diarrhoea, headache and nausea.
When to see your GP
- If your symptoms do not respond within 14 days of treatment.
- If you have repeated or severe episodes, difficult or painful swallowing, vomiting or choking attacks at night.
- If symptoms are not typical, especially if you are over 55 years. Angina (heart pain), stomach ulcer and (rarely) stomach cancer can cause similar symptoms to reflux.
- If you have unexplained weight loss, vomit blood or pass black bowel motions you need prompt investigation.
For further information speak to your GP or go to www.gesa.org.au.
Diabetes causes a raised level of glucose (sugar) in the bloodstream. However when there is an imbalance between diabetes medication, food eaten and physical activity, some people with diabetes experience hypoglycaemia (a ‘hypo’) or low blood glucose (<4mmol/L).
Hypoglycaemia symptoms can range from mild to very serious and can include:
- Dizziness, lack of concentration, change in behaviour or mood, headache, hunger
- Sweating
- Weakness or shaking
- If untreated, confusion, drowsiness, unconsciousness and seizures can follow.
When on certain diabetes medications hypoglycaemia may be triggered by:
- A delayed or missed meal or snack
- Insufficient carbohydrate eaten
- Physical activity which is unplanned or more vigorous than usual
- Drinking alcohol without carbohydrate
- An excessive dose of diabetes medication
Sometimes hypos are not recognised, especially if symptoms are mild or occur during sleep. Some people with long-standing diabetes have no early warning symptoms when their glucose level drops.
Treatment of hypos
If you suspect a hypo, test your blood glucose level if you can. Then take some quick-acting carbohydrate, such as ½ can of soft drink (not ‘diet’) or 6-7 jellybeans. Follow this with some long-acting carbohydrate such as a sandwich or a piece of fruit.
A hormone called glucagon can be given by injection by another person if you are unconscious or unable to treat yourself.
Always tell your GP if you think you may have experienced a hypo, even a mild case. You may need a review of your diabetes management, which could include a search for the reasons for the hypos, a change in the dose of your diabetes medication or a change of medication to one less likely to cause hypos.
Speak to your GP for more information or visit www.diabetesaustralia.com.au.
The internet can be a valuable source of health information that can help you understand your illness and treatment. However, there are many pitfalls in health cyberspace!
A lot of health information online is inaccurate, biased or out-of-date. Anyone can write a website and promote dubious information or questionable products. It can be very hard to tell if a site can be trusted.
One study found that less than 10% of health sites gave advice that was completely in line with established medical guidelines.
Online self-diagnosis is dangerous. It is easy to misinterpret complex medical information and reach the wrong diagnosis. It can also lead to health anxiety (‘cyberchondria’) and over-diagnosis of serious disease.
Discuss any online health information with your GP who can help you process the information and assess its relevance for you.
However, there is rarely time in a consultation to wade through reams of information! Summarise your findings and write a short list of questions before you visit your GP.
New resources on our website
Our practice website now includes a comprehensive range of health resources. It is a good place to start when looking for reliable online information.
All the medical content is written by a GP and is reviewed by 3 other independent GPs and (in most cases) a medical specialist, so you know it can be trusted. It includes:
- Past articles from Your Health newsletter
- Reliable health website links
- A guide to medicines and side-effects
- A medical dictionary
- Health tools and calculators
- Links to healthy recipes
- Lists of patient support groups
Our website is accredited by the international Health On the Net Foundation (HONcode) which assesses health websites for quality and trustworthiness. Visit www.hon.ch for more information.
Which contraceptive is best for you?
Couples now have many different ways to prevent pregnancy. Try to weigh up the pros and cons of each method before choosing the one for you. Here are some of the issues to consider:
Short or long-term method
Long lasting methods suit those who don’t want to think about contraception every day or have trouble remembering to take tablets. They include the vaginal ring (3 weeks), hormone injection (3 months), implant (3 years) and IUD (up to 5 years).
Effectiveness
The implant, IUD and injection are amongst the most effective methods. The Pill and vaginal ring are very reliable if used correctly. Condoms and diaphragms are less effective.
Side-effects
All methods can have unwanted side-effects. If these are troublesome, you may need to discuss other options with your GP.
Sexually Transmitted Infections (STIs)
If you are in a new relationship you should think about using condoms as well as your usual contraception. Condoms provide good protection from STIs if used correctly.
Your medical history
Some women cannot take the Pill for medical reasons. Women with previous blood clots, high blood pressure, migraine and smokers over 35 years should talk to their GP.
Other benefits
The Pill and vaginal ring may make periods regular, lighter and less painful. Some Pills improve acne and PMS. Some women using the progestogen IUD or the hormone injection find their periods disappear completely.
Cost
The lowest cost methods are the hormone implant and progestogen-releasing IUD, although there are insertion costs. The diaphragm and condoms are also low cost.
Visit www.whatcontraceptiveareyou.com for more information and discuss your needs with your GP.
Blood, urine, vomit and other body fluids can leave unsightly and lasting stains around the house. Here are some tips on how to remove them with readily available cleaning materials.
Urine stains on the mattress
Add a little white vinegar to water and use to sponge the stain. Scrub the stain with a cloth. Dry in the sun if possible, or use paper towels, then a hairdryer. Neutralise the smell with lemon juice or white vinegar applied sparingly with a damp cloth.
Old vomit stains on the carpet
Apply glycerine with a cotton ball. Then rot some milk in the sun and apply the solids to the stain with a cloth. Leave until almost dry, vacuum and wash the solids out with a damp cloth. Then clean with carpet cleaner.
Semen stains on the sheets
Damp a cake of soap in cold water and rub over the stain. Then rub the stain against itself until it is removed. Put the sheets in the washing machine on the cold cycle.
Blood on clothing
Wash fresh bloodstains through the washing machine on the cold setting. If you can’t, use cornflour and water. For old bloodstains, use cold water and soap.
Sweat or deodorant marks on clothing
Make a paste with Napisan Oxygen (not plain Napisan) and water to the consistency of peanut butter. Apply to the stain for 15 minutes. Then wash as usual in the washing machine.
Can pregnant women have flu injections?
Yes. The flu vaccine does not contain live virus and can be safely given in pregnancy. Vaccination is recommended for all women who will be in the second or third trimester during the flu season.
Have your flu shot now to be ready for a winter epidemic.
What is the deadline for FREE HPV vaccine?
Young women aged 18-26 years are eligible for free HPV vaccine as long as they have their first injection by 30 June 2009. HPV vaccine helps prevent cancer of the cervix.
The course of 3 injections needs to be completed by 31 December 2009. After that, the vaccine costs $150 per dose.
www.immunise.health.gov.au
Give your child a cool lunch box!
Children need healthy food at school for learning, concentration, energy and growth. The challenge for parents is to provide nutritious food that their child will be happy to eat. Here are some tips that may help:
1. Choose foods that your child enjoys
Talk to your child about foods that he or she likes or dislikes. Children enjoy foods they have helped to choose or prepare but try giving a choice between healthy foods.
2. Choose foods that are easy to eat
Children want to finish eating quickly so they can play. Cut sandwiches into quarters or long fingers and cut fruit into manageable sizes.
3. Keep food cold
Cold food is more appetising and is safer from food poisoning bacteria. Put the lunch box in the fridge until it is time to go. Place an ice brick in the lunch box or keep it in an insulated cooler bag.
4. Limit ‘sometimes’ foods
Foods such as chocolates, lollies, fruit roll-ups, sweet biscuits and chips are high in sugar and/or fat and offer very little nutrition. Children tend to eat these foods before, and instead of, the other food.
5. Choose water as a drink
Remind your child to drink regularly, especially in warm weather. Water is the best drink. Try filling a water bottle to a third or half full and freeze overnight. Top up with cold water in the morning.
6. Choose a good lunch box
Food which becomes bruised or squashed is unappetising and is less likely to be eaten. Try to fit the food snugly in the lunch box so it can’t be jumbled around.
Source: Lunch Box World at http://www.meerilinga.org.au/Nutrition/LunchBoxWorld.aspx. Check it out for lots of healthy lunch box food ideas.
When are child headaches serious?
Headaches are unpleasant in children but rarely have a serious cause. It can be very difficult for parents to know when to seek medical care.
Common benign headaches
Most headaches are benign (harmless) and do not need medical assessment. Fever and viral infections (e.g. flu, head cold or throat infection) are very frequent causes. Most settle with time and paracetamol.
Migraines are also common in children and often run in families. The pain is usually throbbing and on only one side of the head. The child may also have nausea or vomiting and be sensitive to light or noise. Episodes usually last 2 -12 hours and generally improve with sleep.
Tension-type headaches are caused by tightening of the muscles in the neck and scalp. They cause a dull, aching pain which often lasts all day and feels like a tight band around the head.
Other benign causes are excess caffeine (e.g. from energy drinks), lack of sleep, too much sun, overuse of pain medication, menstruation and medicines.
Rare, but serious headaches
Serious headaches are rare. They include infections around the brain (meningitis), head injuries and brain tumours. Contact your GP if your child has unexplained, severe, frequent or persistent headaches or:
- Seizures or a recent head injury
- Neck pain or stiffness
- Unusual sleepiness or difficulty standing
- Headache waking the child from sleep or present on waking in the morning
- Skin rash, persistent vomiting or disturbed vision
A headache diary can help your GP assess the problem. Write down when headaches occur, their severity, how long they last, any triggers and other symptoms.
More info: Royal Children’s Hospital fact sheet: http://www.rch.org.au/kidsinfo/factsheets.cfm?doc_id=12103
‘No added fat’ beef & mushroom stir fry
Suitable for people with diabetes
Nutritional analysis per serve: Total fat 8g, saturated fat 3g, carbohydrate 16g, 1240kj.
Low GI.
Preparation: 20 minutes + 20 mins to marinade. Cooking: 5–7 mins.
Ingredients
600g lean steak
1 tblspn minced red chilli
1 tblspn minced garlic
¼ cup Tamari salt-reduced soy sauce
1 cup low-salt, no-fat beef stock
1 medium onion, cut in thin wedges
1 red capsicum, cut into strips
100g sliced medium mushrooms
20g grated green ginger
2 cups sliced Chinese cabbage
200g cooked rice vermicelli noodles
1 cup coriander leaves only
Preparation
1. Trim all fat off the beef and cut into fine strips. Put in bowl with chilli, garlic and soy sauce. Turn well and leave to marinade for 20 minutes.
2. Pour half the beef stock into a wok and bring to boil over high heat. Add onion and capsicum and stir fry for 2 minutes. Drain the beef and add.
3. When the beef is lightly browned and is combined with the onion and capsicum, add the rest of the stock, mushrooms and ginger. Stir fry for two minutes and then add the cabbage and cook to combine.
4. Serve in bowl with the stir fry spooned over the rice noodles and topped with ripped coriander leaves.
Source: Delicious Living cookbook by Peter Howard. RRP $19.95.
Endorsed by and available through Diabetes Australia. T: 1300 136 588.
