Sleep apnoea

Posted on September 17, 2019 by admin
In Medical

 

Found  in  6-17% of the  adult population and associated with symptoms of fatigue and sleep that is not refreshing, poor  concentration  low  or depressive mood. Other  presentations may be altered driving  behaviour , cognitive  deterioration ,  and  non breathing periods  during sleep.

Often associated factor  are airway obstruction , obesity  difficult  to  control hypertension, fatigue,   poor  motivation or depression.

 

Investigation includes clinical history , screening  questionnaire, appropriate  physical  examination,   and sleep studies by polysomnogram which may  be done  in certain case  by home  telemetry or formal laboratory  hospital based sleeps studies.

Treatment is by correction of underlying   physical  factors  and    the  use of  C-pap  positive  pressure devices  occasionally dental splinting   and  corrective  ENT  surgery may be  appropriate.

Patient Health Summaries

Posted on August 6, 2019 by admin
In Medical

The patient  health summary is the  most  useful information you can present to a doctor you are seeing  for the first time or when attending Accident  & Emergency or being admitted to   hospital.  Patient  health  summaries are  readily printed by your GP and  ususally  are  1-2 A 4 pages that are easily carried and read by a health professional. They also faciltate any practitioner  contacting your regular doctor and assist  in providing  the  address for communicating results , correspondence  and discharge summaries to.

 

We encourage you to ask  your doctor to print you a copy to carry

Children and inhaled foreign bodies

Posted on July 5, 2019 by admin
In Medical

Approximately 1000 children  die from inhaled foreign bodies  per year  and around the age of   3 yo. Mostly between  1 –2  yo. The  most  common  inhaled  objects are  food and nuts but  potentially any  small item.

A history of choking /coughing with associated respiratory distress like  wheeze noisy whistling  breathing ,  “ turning blue “ with coughing or wheeze., a subsequent  quiescent  asymptomatic phase may prevail  then be  followed  by  respiratory complications  like bronchitis  or pneumonia  with symptoms  of  cough , fever  and being generally unwell.

Metal and glass objects  may show  on  xray but plastic and food  or other organic objects will not . A swallowed  battery is a an urgent  medical emergency because of its  corrosive nature. Especially  beware  hearing aid , watch and  other  button batteries.

It is recommended that  hard lollies  , popcorn  , raw carrot , raw apple be avoided under  15 months and nuts  not be  offered until after 4 yo

 

Chest thrusts  or  back slaps  are  appropriate during  choking episodes.

If suspicious  of  foreign  body ingestion or aspiration   a  GP  or  A&E review  is appropriate   Specialist   paediatrician ENT review  may be  required.

 

Community “ herd “ immunity

Posted on June 9, 2019 by admin
In Medical

Community  immunity  protects   those  members of the community  who cannot or  have  not  already been vaccinated  – like the  immunocompromised  with serious other illness like cancer  or dialysis, old age debility , those undergoing  chemotherapy and  new borns  not  yet vaccinated. To achieve community immunity  at least   92% of the community need to be vaccinated.

Potentially  life threatening diseases that  are  vaccinated against in Australia are: Diptheria , Whooping  cough , Tetanus , Poliomyelitis, Measles, gastroeneteritis from Rotavirus.and chickenpox

Additionally  significant  diseases  like  cancer of the cervix, meningococcal infection, hepatitis B  pnemococcal disease are  also  vaccinated through  school  and  retired  age group programs .

 

Osteoarthritis

Posted on May 4, 2019 by admin
In Medical

“ use  it  or lose it  “  is  a useful adage  to remember  for  osteoarthritis  especially of weight  bearing  joints.

Weight  reduction of   5% in  20  weeks  is a  worthwhile  goal to aspire  to with  real benefits remembering that for every 1 kgm  weight loss  there is a 4kgm reduction in pressure  on the major  weight  bearing  joints of the leg  like the knee.

Regular Exercise   reduces  pain and maintains or  improves  joint function. Balance training  reduces   the  likelihood  of falls  and  enhances  joint movement.

Active  aerobic  exercise  should be  done  for   30 mins / day – most  days at a level that  makes you breathe  hard  but  still able to speak about 7 words at  a time. Walking  is  very easy  especially if done as part of  a lunch break  or  part  of the daily commuting walking to transport  or the car park. 3 x  10 min burst of  intense  exercise have also  been found to be  of similar benefit

 

Strengthening exercises should be done at least  3 x /week involving  core strength exercise , quadriceps hamstrings  hip abductors and calf muscles. Therabands  or light weights are  useful. Exercises to consider – standing leg  side  raises; sit to stand from chair ( no hands); calf raises  ( tip toes );  one  or  two step up and down – facing stairs  , side steps –  face  left and face right, have support  rail   or bannister next to the step for safety. Straight leg  raises and  knee  straightening when seated.

 

Flexibility exercises at  least  3 x/week for  at least the knee  and hip as well as the  back involving  stretches  and  rotations for  15-30 seconds  repeated  3-4 times  at least  3 x/week.  Quadriceps ,  hamstrings , hip flexors and abductor stretches

 

Water  based  exercise 2  x  /week for  30 mins  is a valuable  addition because  of  constant resistance, the  soothing  effect on  joints, the  improvement  Water aerobic  or  exercise  classes are a useful  adjunct. Consider  walking in  above  waist  height  water  , swimming ,  bicycling    action , star   jumps  and  lunges  also the  use  of   resistance   equipment  like  noodles  paddles   and  kickboards.

Ask  your  doctor , physiotherapist  or   trainer  for advice.