Newsletter "Your Health"
- Smoking. Are you ready to quit?
- Type 2 diabetes. Do you need insulin?
- Swimmer’s ear
- Many options for heavy periods
- Your own GP. Why you need one
- Can herbal remedies help back pain?
- What’s new in treating ‘cold sores’?
- Teenage periods. What is ‘normal’?
- Toilet training. When to start?
- Eggs and your health
Smoking. Are you ready to quit?
If you smoke, quitting is the best thing you will ever do for your health. Smoking causes more death and disease in Australia than any other preventable cause.
Smoking rates are falling. Millions of Australians have embraced a healthier smoke-free lifestyle, and you can too.
Are you ready to quit?
Your motivation to quit fluctuates. At any one time 20% of smokers are actually ready to quit (although 80-90% of smokers want to quit). This is a window of opportunity when you are most likely to succeed. Don’t waste it!
Are you addicted?
Nicotine is one of the most powerful addictive substances. After quitting, 80% of smokers experience nicotine withdrawal symptoms such as depressed mood, insomnia, irritability, anxiety, difficulty concentrating, increased appetite, weight gain and cravings.
You are likely to be addicted if you smoke within 30 minutes of waking up or have more than 10-15 cigarettes per day. Medication can help you (see below).
How to succeed this time
Trying to quit on your own has a success rate of only 3-5%. However, there are proven strategies which will substantially improve your chances.
For addicted smokers, medications are used to relieve withdrawal symptoms and can double or triple success rates. Nicotine replacement therapies (e.g. patch, gum, lozenge) are available over-the-counter and there are non-nicotine prescription medicines from your GP.
However, smoking is more than just a drug addiction. It is also a powerful habit. Research has shown that advice and support from your GP to help you break the smoking habit can dramatically increase your chance of success.
Even with help though, most attempts are not successful. That’s OK. Each time you try it gets easier. You learn from every quit attempt and you will eventually beat the habit. Try and try again!
If you are ready to quit, don’t waste the opportunity. See your GP today and give yourself the best chance. For more help, ring Quitline 137 848 or visit www.quitnow.info.au or www.quitnow.info.au.
Type 2 diabetes. Do you need insulin?
Type 2 diabetes is a progressive disease. Diet, exercise and tablets control it for a while, but the time will come when many patients will need insulin. 50% of patients require insulin within 6 years of diagnosis.
Insulin is produced by the beta cells within the pancreas gland in the abdomen and helps keep blood glucose at normal levels. Over time, less insulin is produced and because the body is already resistant to insulin, this leads to raised glucose levels, feeling unwell and long-term complications.
Aim for an A1C <7%
The gold standard for measuring your glucose control is the A1C blood test (HbA1C or glycosylated haemoglobin). The A1C is a reliable guide to your diabetes control over the last 2-3 months. If your A1C is consistently over 7% in spite of maximum oral drug therapy, you may need insulin.
Insulin is your friend!
Many people are afraid of starting insulin. However, it is safe and simple and makes people feel better. Insulin injections are virtually painless and reduce your risk of complications e.g. eye, kidney and nerve damage.
Insulin is usually started as a single dose at night and your current diabetes tablets are continued. There are several disposable and reusable insulin ‘pens’ available which are easy to use. You simply dial up the dose and inject, usually into the skin of the abdomen.
Insulin may cause weight gain which can be reduced by eating less and exercising more. There is also a small risk of hypoglycaemia (low blood sugar). Testing blood glucose levels at home on a fingerprick sample using a blood glucose meter is essential.
Don’t be frightened. Many patients say they wish they had started insulin earlier. Speak to your GP today or contact Diabetes Australia: ring 1300 136 588 or go to
www.diabetesaustralia.com.au.
SWIMMER’S EAR
Swimmer’s ear (otitis externa) is a common infection of the skin lining the ear canal, the tube which carries the sound from the outside to the eardrum.
The condition is usually due to water remaining in the ear canal after swimming (particularly in polluted water) or showering. Moisture makes the skin soggy, allowing bacteria or fungal infections to take hold. Scratching the skin with a cotton bud or paper clip can also lead to infection.
Swimmer’s ear often causes pain (sometimes severe), made worse by pulling the ear. There may also be a smelly discharge, an itch and a blocked feeling.
Treatment of swimmer’s ear
Swimmer’s ear is usually treated with careful cleaning of the ear canal (by your doctor) and eardrops containing an antibiotic, a steroid and an antifungal agent.
Drops are used 2-3 times daily for up to a week. When using drops, lie down with the affected ear upwards. Insert the drops and gently pump them into the ear by pushing on the skin in front of the ear canal for 30 seconds. Stay lying for several minutes.
In more severe cases, an oral antibiotic is needed and paracetamol or aspirin may be required for pain. Eardrops containing benzocaine (an anaesthetic) or a warm pack can also give pain relief.
It is important to keep the ear dry during treatment and for 2 weeks afterwards.
How to prevent further attacks
If you are prone to repeated infections you should keep your ears dry. Waterproof earplugs or a shower cap can keep out the water while swimming or bathing. Moisture can be removed afterwards with alcohol drops or a hair dryer on a low setting.
www.cyh.com > Health Topics
MANY OPTIONS FOR HEAVY PERIODS
Heavy periods (menorrhagia) are a common and distressing problem, especially between 30-50 years of age.
You may have menorrhagia if your periods are long (>7 days) or heavy (flooding or blood clots). This can lead to tiredness, low iron levels and anaemia.
Heavy bleeding should be assessed by your GP for an underlying cause. A pelvic examination and a blood test for anaemia and iron are usually needed. A pelvic ultrasound is often advised and sometimes a sample of cells is taken from the uterus.
The causes of menorrhagia include:
- Fibroids (benign tumours of the uterus)
- Polyps (growths on the lining of the uterus)
- Adenomyosis & endometriosis (cells from the uterus growing in the wrong places)
- Cancer of the uterus (uncommon)
In many cases no cause for the heavy bleeding is found. It is then known as ‘dysfunctional uterine bleeding’ (DUB).
Several different medications are available which can reduce bleeding. These include tranxenamic acid tablets, anti-inflammatory tablets, the Pill and progestogens (tablets, injections or implants).
However, polyps, fibroids and uterine cancer may require surgical treatment.
What’s new for menorrhagia?
The most effective medical treatment for reducing blood loss is the IUS (intrauterine system). This small, plastic, T-shaped device contains a hormone (levonorgestrel), and is inserted by the doctor into the uterus.
The IUS is well tolerated, although irregular bleeding and spotting are common in the first 3-6 months of use. By 12 months, most women have only light bleeding and many have none at all.
The device has recently become available on the PBS for heavy periods. It is especially useful for women who also need contraception and can help avoid the need for a hysterectomy (removal of the uterus) in others. It can remain in place for up to 5 years.
www.jeanhailes.org.au
Your own GP. Why you need one
A good, ongoing relationship with the one doctor is vital for optimal health. Over time, your GP gets to know your personality, medical history, family background and vulnerabilities.
Continuous care
It is always best to see your own GP when you can. Dropping into different clinics for a script or other quick problem may be convenient but detracts from the quality of your medical care. Your doctor gains a deeper understanding of your unique health needs with every visit.
What is the underlying problem?
Illness is an opportunity to reflect on the causes of poor health. Many problems are due to anxiety, depression and lifestyle issues e.g. overweight, smoking and lack of exercise. Quick visits to different doctors rarely address these crucial underlying issues.
Good preventative care
Your own doctor knows when your immunisations, Pap smear and cholesterol test are due and can send reminders. Regular reviews will keep you in tip-top shape.
What about ‘specialised’ clinics?
Skin clinics, STI clinics, impotence clinics, heart clinics etc are run by GPs and offer no advantage over your own doctor’s care. Your doctor knows your full health profile and is in the best position to treat you.
What about alternative practitioners?
If you visit an alternative practitioner, see your GP first for the right diagnosis. For example, massage may help back pain but not if it is due to a stomach ulcer or leaking aneurysm. Your GP is trained to diagnose these rarer but life-threatening conditions.
Source: 101 Things Your GP Would Tell You If Only There Was Time, Dr Gillian Deakin.
Can herbal remedies help back pain?A recent ‘Cochrane Review’ (a detailed analysis of all research studies to date) found that several herbal medicines may be effective for short term treatment (4-6 weeks) of low back pain. There is good evidence for Harpagophytum Procumbens (devil’s claw) and Salix Alba (white willow bark) and a probable benefit from Capsicum Frutescens (cayenne).
What’s new in treating ‘cold sores’?
Cold sores are an infection with the herpes simplex virus, most commonly around the mouth.
A single dose (3 tablets) of the antiviral drug famiciclovir is now available on private prescription from your doctor. It reduces pain and tenderness and shortens the healing time by about 2 days. Treatment should start as soon as possible after symptoms appear.
Teenage periods. What is ‘normal’?
Period problems are common in the teenage years and many girls wonder if their periods are normal.
The first period (menarche)
Puberty usually begins between 8 and 13 years of age. Breast enlargement and a growth spurt are the first signs, followed by pubic and underarm hair.
The first period usually arrives about 2-2½ years after puberty starts, at an average age of 13 years. The starting age is often about the same as your mum or sisters but can be delayed by excessive dieting or exercise. Speak to your doctor if your periods do not start by age 17.
The first 1-2 years of periods are often irregular. The cycle length (time from the start of one period to the start of the next) is 28 days on average (range 21-45 days).
Heavy periods (menorrhagia)
The amount and length of bleeding vary greatly from one girl to another. Periods last 4 days on average (range 3-7 days) and most teens change pads or tampons 3-6 times a day, with more frequent changes when the period is heaviest.
Prolonged (more than 7 days) or heavy (flooding or clots) periods are common in the first few years and may require treatment, usually with hormones or the Pill.
Period pain (primary dysmenorrhoea)
Many girls get period pain during the first 1-2 days of bleeding each month. The pain is usually crampy and is felt in the pelvis, lower back and upper thighs.
Period pain is caused by spasms of the uterus (womb) and can be very severe. Anti-inflammatory drugs (e.g. mefenamic acid, naproxen) or the Pill usually give relief. TENS (electric nerve stimulation), Vitamin B1 (100mg daily), acupuncture and exercise may also help.
Periods shouldn’t get in the way of exercising, having fun and enjoying life. Speak to your parents or doctor if you are worried or visit www.kidshealth.org.
Toilet training. When to start?
The key to toilet training success is waiting till your child is ready. Try to avoid pressuring your child and give lots of praise.
When is my child ready?
Most children are ready to start toilet training from about two years, with boys a little later than girls. However, some children are not ready till much later. Signs that your child may be ready include:
- Telling you before he needs to go
- Telling you when he is doing or after he has done a wee or poo
- Having a dry nappy for 2 hours
- Pulling at wet or dirty nappies
- Taking an interest in others using the toilet
- Disliking wearing a nappy at all
Pick a time that is not stressful, for example not around the birth of a sibling!
How to get started
- Choose either a potty or a toilet with a special toilet seat and a step
- Stop daytime nappies. Use underpants, training pants or no pants at all!
- Sit your child on the potty when a poo is likely, e.g. 15-30 minutes after a meal
- Look for signs he is ready e.g. a change in posture or going red and straining
- Limit sitting to 5 minutes at a time
Be patient! Toilet training typically takes 3-6 months. Inevitably, there will be accidents and setbacks. Give lots of reassurance when this occurs and try to avoid showing any disappointment. Offer lots of praise and cuddles for small steps forward or even for just trying.
For authoritative advice on raising children: http://raisingchildren.net.au.
EGGS AND YOUR HEALTH
Most people are surprised to hear that eating eggs has little effect on cholesterol levels in healthy people. Saturated fat is the main villain in raising cholesterol and the fat in eggs in mostly unsaturated.
Eggs can also be part of a weight control diet. Two eggs provide the same number of kilojoules as a small tin of salmon. They are a good source of vitamins as well as protein, which helps to reduce appetite.
Eggs can be eaten in moderation as part of a healthy, balanced diet.
Asian style omelette
Serves 4. Cooking:10 mins
P serve: 885kJ, 13g fat (3.5g saturated)
Ingredients
Olive oil spray
400g mushrooms, sliced (use a mixture e.g. button, shittake, oyster)
8 eggs, lightly beaten
3 green onions, sliced diagonally
1 tbsp kecap manis (Indonesian soy sauce)
¼ cup coriander leaves
Method
Spray a small non-stick frying pan lightly with oil. Add mushrooms & stir fry for 2 minutes until soft. Set aside.
Wipe out the frying pan and spray again. Reheat pan and add ¼ of the eggs. Swirl to cover the base, and cook for about 2 minutes, dragging uncooked egg from the edges into centre. When almost set, spoon ¼ of the mushrooms and ¼ of the onions onto half of the omelette.
Fold the omelette over the filling. Slide onto a plate, drizzle with kecap manis and sprinkle with coriander.
Repeat with remaining ingredients to make 4 omelettes.
More egg recipes: www.eggs.org.au
