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Showing posts from 2016

"Doctor does this mole matter?"

What would you say is the most common cancer in the UK?  It is not lung cancer, breast cancer or bowel cancer. Nor is it prostate, ovarian or cancer of the cervix. The answer believe it or not, is skin cancer, with 100,000 new cases diagnosed in the UK each year. That’s 274 a day. The good news is that it is both treatable, and in many cases preventable. An individual’s risk is determined by a mixture of factors including not just sun exposure, but genetics, the number of moles you have and how fair skinned you are. Doctors grade skin types by what is known as the Fitzpatrick scale, from the fair skinned ‘Type 1’ (always burns, never tans, pale white; blond or red hair; blue eyes; freckles) to the dark skinned ‘Type 6’ (Never burns, never tans, deeply pigmented dark brown to darkest brown skin). Generally your risk is higher the lower your ‘type’. We have known for years that ultraviolet exposure (UV) from the sun is the primary cause, with sunburn being a particular trigger for changes…

Vaccination: quick and (almost) painless

Following on from my last blog regarding the HPV vaccination and how it has benefits for both boys and girls, it is interesting to see that new guidelines have been developed to help doctors and nurses who inject children.  These guidelines focus on how we can reduce distress for the child. As a parent, and a GP, I am very familiar with the stress that comes with having one of your children vaccinated.  There’s no escaping the fact that for a brief moment, the jab is going to cause a prick or a sting, and all we can do is comfort our children and distract them if possible, safe in the knowledge that we have acted in their very best interests.  It is always over very quickly and soon forgotten, but the lead up to vaccination day can be a source of anxiety.  Mums and Dads sometimes find the process too tough to handle, and we frequently see the task delegated to Grandparents or one parent in particular, no doubt after much personal deliberation!
Why are the guidelines important? I hope it…

HPV vaccine (Gardasil) - not just for girls

Preventing cancer. Anyone with a teenage daughter will be familiar with a relatively new vaccination provided in year 8 at school, which is designed to protect against cancer of the cervix. In the UK this is the second most common cancer to affect women under the age of 35, with around 3000 cases per year (8 cases per day) being diagnosed. Unfortunately death rates are high - around 970 women died from cervical cancer in 2011 in the UK. The jab, GARDASIL, represents a truly dramatic improvement in healthcare. Just consider what this vaccination gives us – a proven and effective vaccination against a form of cancer. We often hear about the search for a cure for cancer, and here we have one step better – true prevention. No wonder it has become a routine childhood vaccination across developed countries all over the world.
But what about the boys? Clearly boys and men are not at risk of cancer of the cervix, but there are very real benefits to boys being vaccinated too. For now however, the …

My child won't stop coughing!

We have all no doubt noticed how coughing among children is practically the norm, especially in pre-schoolers. At any one time, research suggests that parents will report coughing in nearly a third of children. What’s more, the impact can be significant: poor sleep, reduced performance at school, parental anxiety, even a household awake all night long. The most common cause is an acute viral Upper Respiratory Tract Infection (URTI) which healthy children experience several times each year. A quarter of these will continue to have a cough 2 weeks after the infection, possibly longer. Assessment and treatment of cough  is an area under continuous review by the guiding medical bodies, most notably the British Thoracic Society.
Information on the internet about cough is generally inaccurate As GPs we often view the internet as a double edged sword. It can be invaluable as a source of useful information for self-management, however misinformation is everywhere. A study was set up to investigat…

How to help your child deal with anger - Dr Kirren Schnack Clinical Psychologist

All human beings get angry. We’re supposed to, evolutionarily speaking it helps us to survive when our fight or flight options get restricted down to the former. But anger can of course also be damaging, it can overwhelm us, especially when we’re under-experienced at anger management.
Why does my child get so angry at everything?
Children are a pot of boiling emotions, with little experience of how to deal with their emotions in moderation. This is actually a physiological situation – your little darling’s frontal cortex (where he or she does their thinking, planning, and decision-making) is still in the process of growth. So, emotionally-speaking, they’re like a car heading out into the world without a fully-configured braking system. While they can go from 0 to 10 on the anger-meter in appropriate situations, they can hit the same anger peaks in situations where they haven’t actually been threatened in any meaningful way, and this can seem as though it is disproportionate. Certain feel…

Will general practice as we know it survive in this economic climate?

We are not sure.  Below is a document written by a local GP colleague who is trying to raise awareness of the pressure that NHS GPs are under.  Reading it, I am struggling to see how the wonderful NHS GP service that we know and love is going to survive.  We are posting it to help with awareness as we fully support our NHS GP colleagues and believe that the role of GP is such a crucial one to this nation.  Here it is:


£136 per year – what can you buy?
- 11 months pet insurance; it costs £151 to insure one rabbit for a year with Petplan - 6 months mobile phone use; one year on a Vodafone sim-only tariff costs £264 - 5 months Sky TV family bundle  - less than 3 tanks of fuel for a Vauxhall Astra - coffee on your way to work for 3 months
Or…
…one year of funding per patient for the average general practice.
Yes. £136. Less than the cost of pet insurance, or a mobile phone, or Sky TV, or 3 tanks of fuel. And many practices get far less than this. And what do you get for your £136? As many consu…

Preventative medicine? What really works?

There is much debate about whether population screening for medical conditions is really useful in the long run.  When you look at the figures for screening performed on healthy people it is amazing what a small chance you have of both picking up some sort of health problem and of prolonging and saving a life as the result of a screening test.  Huge numbers of people have to go through procedures, all with some sort of risk, to produce an incredibly small change in the overall chance of saving or prolonging life.

That being said there are a few things that I believe are worthwhile in terms of preventative medicine.  Here are three simple ones that come to mind:

1.  To me, preventing pregnancy when you don't wish to have a baby is the by far the most significant intervention that you can make in the life of your patient.  I am amazed at the privilege that we, as a nation, have in being able to choose when we wish to have a baby.  And these days there are great improvements in the t…