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.
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
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 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 .
“ 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.