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Self Help

coldWe are keen to help patients improve on self help and hope that the following information will offer some insight into that.

Take a look and see if you can improve your own understanding of your health and well-being! Please encourage others to look here too.

Here is a list of ailments that can be safely self managed. You will see that you can take a look via the hyperlink at the other websites which can offer you further information about managing your condition.

Common ailments that can be self managed :

Acne (Spots):

This fact sheet helps you to know what’s ‘normal’ and what you can expect to happen if you suffer from acne (spots). It also tells you when you should become concerned and seek advice from a health professional.

Useful facts

What is acne? Acne tends to start at puberty and leads to greasy skin and ‘spots’. People may feel bad about themselves because of the way their skin looks, often at a time when they’re already vulnerable.

How common is acne? You’re not alone – acne affects more than 8 out of 10teenagers to some degree, and more frequently boys. Around one in three teenagers have acne bad enough to need treatment. In women, acne is more common around the time of their monthly periods.

What’s causing it? Acne is caused by inflamed skin glands on your face and upper trunk, sometimes caused through an infection. In rare cases, acne may be caused by an underlying medical condition, such as polycystic ovary disease (PCO) or other hormonal disorders. It’s a myth that stress or certain foods (such as chocolate) cause acne – and acne is certainly not due to a lack of cleanliness!

What can I expect to happen?

Duration Acne is a long-term condition that may need immediate treatment for treating severely affected skin, and maintenance therapy to keep spots from recurring. In 7 out of 10 people, acne stops within five years – but some people may suffer lifelong.

Severity Acne can vary from being mild and localised to severe and widespread.

Impact on your life Acne can severely affect people’s quality of life, regardless of how bad it is.

Tests You won’t need any tests unless your doctor suspects an underlying medical cause.

What can I do myself to get better – now and in the future?

Washing Wash your face only once or twice a day with lukewarm water. Avoid strong or abrasive soaps and excessive scrubbing. Be aware that hot water and rough flannels can make symptoms worse rather than better.

Avoid squeezing No matter how tempting, try not to squeeze spots, as this may cause scarring.

Over the counter creams, gels and lotions Effective treatments are available to reduce and improve spots. They can also prevent or reduce scarring if started early. Ask your pharmacist for advice on available preparations. You need to continue treatment for at least six weeks before seeing any changes. If a treatment is effective, continue for at least four to six months. You may need to try different preparations until you find one that suits you. Some treatments may irritate your skin initially, so seek advice from your pharmacist if this is the case.

When should I seek medical help?

Seek advice from your pharmacist or GP if initial treatment with over the counter preparations doesn’t work for you, if acne significantly impairs your quality of life, or if any of the following warning symptoms are present:

Severity Your acne is really bad and you feel physically unwell because of it.

Pain You develop painful spots that feel ‘deep’ in your skin.

Distress You get distressed by your acne, and/or it affects your social life.

Scarring You notice the beginning of scarring despite treatment.

Possible underlying medical causes You suspect that you may have an underlying medical condition that causes your acne – for example, if you have additional symptoms such as infrequent or absent periods, excessive hair growth, or hair loss.

Where can I find out more?

Check out the NHS Choices website (http://www.nhs.uk/conditions/Acne/ Pages/Introduction.aspx) for more information on how you can treat and prevent acne. Remember that your pharmacist can also help you with assessing your symptoms and advise on suitable treatments.

The common cold (adults):

This fact sheet helps you to know what’s ‘normal’ and what you can expect to happen if you develop a cold. It also tells you when you should become concerned and seek advice from a health professional.

Useful facts

What is the common cold? Mild viral infections can cause symptoms of the cold, including a blocked and then runny nose, sneezing, cough, a sore throat, a slightly raised body temperature (fever) up to 39°C and feeling generally unwell.

How dangerous are colds? Colds are harmless infections that in the vast majority of cases get better by themselves without any complications.

How common are they? Colds are very common, and adults get an average of two to four colds a year.

Are there any complications? While the symptoms are unpleasant, the common cold is harmless. Complications, such as chest, ear and other infections, are rare.

Will I need antibiotics? Most colds get better on their own without treatment. Antibiotics are ineffective for treating the common cold and may cause side effects.

Effect of smoking: Cold symptoms such as coughing tend to be more severe if you smoke, and the infection usually lasts longer.

What can I expect to happen?

Symptoms: In adults and older children, cold symptoms last for about a week and a half, and in younger children for up to two weeks. Symptoms are usually worst in the first two to three days, before they gradually start to improve. Coughs may last up to three weeks.

There is no cure: We have no cure for the common cold. But while our bodies fight the infection, there are various ways of relieving our symptoms.

Catching a cold: We can catch a cold by either breathing in droplets of fluid containing the cold virus (when someone sneezes), or by touching something that someone has sneezed on, and then touching our mouth or nose.

Produced by the Self Care Forum (www.selfcareforum.org). Last revised on 30 Oct 2013. Please contact Libby Whittaker 020 7421 9318 or email libby.whittaker@selfcareforum.org with comments or suggestions.

What can I do – now and in the future?

Simple measures: Get some rest until you feel better – we usually know when we’re well enough to return to normal activities.

Diet and fluids: Eat healthily, including at least five portions of fruit and vegetables every day. Drink plenty of fluids to replace those lost from sweating and a runny nose.

Over the counter medicines: Paracetamol, ibuprofen or aspirin can help reduce the symptoms of a cold. Avoid giving aspirin to children under the age of 16 and follow the manufacturer’s instructions. Talk to your pharmacist about supplements that may help ease your symptoms.

When should I seek medical help?

Most colds are not serious and get better by themselves. Contact your GP surgery for urgent advice if you notice one or more of the following:

 You develop a high temperature (above 39°C or 102.2°F), which can be a sign of amore serious type of infection;

 You’re feeling confused or disorientated;

 You notice a sharp pain in your chest;

 You cough up blood-stained phlegm (thick mucus);

 You find it difficult to breathe;

 You notice a marked swelling of the glands in your neck and/or armpits;

 Your symptoms last longer than three weeks.

Where can I find out more?

Visit NHS Choices (http://www.nhs.uk/Conditions/Cold-common/Pages/Introduction.aspx) or Patient.co.uk http://www.patient.co.uk/health/Common-Cold.htm for more information on what you can do if you suffer from a cold. Remember that your pharmacist can also assist you in assessing your symptoms.

Constipation:

This fact sheet helps you to know what’s ‘normal’ and what you can expect to happen if

your stools or, less formally, poo are too hard and/or difficult to pass (known as

constipation). It also tells you when you should become concerned and seek advice from a

health professional.

Useful facts

What is constipation? Constipation is when your stools become hard and you

find it more difficult than usual, or even painful, to pass them when going to the

toilet. You may also have a feeling of being unable to completely empty your

bowel. Opening your bowels may be more difficult because your stools are hard,

lumpy and dry, or because they are abnormally small or large.

Other symptoms Constipation may be accompanied by feeling bloated or sick,

losing your appetite, and aches or cramps in your abdomen.

How common is it? You’re not alone – constipation is very common (particularly

in women and older people) and affects an estimated one to two out of 10

people at any one time.

Common causes These include not eating enough fibre (contained in cereals,

vegetables and fruit), changing your eating habits, ignoring the urge to go to the

toilet, not drinking enough fluids, not getting enough exercise and, perhaps

surprisingly, also mental health problems such as depression or anxiety. Certain

medications, such as opiates, diuretics and antidepressants may also cause you

to become constipated.

What can I expect to happen?

Normal stool frequency We’re all different when it comes to bowel habits

some of us pass stools only every three or four days, whereas others may go

more than once a day.

Constipation is usually harmless Being constipated once in a while is common

and usually completely harmless.

Duration In most cases, constipation is short-lived and settles within a few days

or 2 to 4 weeks at the most.

Investigations There is usually no need for any investigations or procedures,

because the diagnosis can often be made based on the symptoms alone.

Where can I find out more?

NHS Choices (http://www.nhs.uk/Conditions/Constipation/Pages/Introduction.aspx) and

the Choose Well website (www.choosewellmanchester.org.uk/self-care) provide

further useful information about constipation. Remember that your pharmacist can also help.

Cough in Adults:

This fact sheet helps you to know what’s ‘normal’ and what you can expect to happen if you develop a cough. It also tells you when you should become concerned and seek advice from a health professional.

Useful facts

Types of cough A cough may be acute, lasting less than three weeks, or chronic, when it may go on for more than eight weeks. Cough can also be dry or productive of sputum (phlegm).

Frequency Most adults experience episodes of coughing between two and five times a year, and about one in five people suffer from coughs during the winter months.

Rarely serious Although coughing often impairs people’s quality of life, it israrely due to serious causes and usually gets better by itself.

What causes coughs? Acute cough is most commonly caused by a viral upper  respiratory tract infection (URTI) due to a cold. A chronic cough is common in smokers and can sometimes suggest an underlying lung problem, but may also be caused by conditions outside the lung, such as heartburn (gastric reflux). Cough may also result from taking certain drugs (check the label), asthma, and environmental factors (dusty workplaces, for example).

What can I expect to happen?

Coughing is usually harmless Although coughs can be distressing (both foryourself and others living or working with you) and a nuisance because they often last for several weeks, acute coughs are almost always harmless and usually start to improve within three weeks.

No need for antibiotics Antibiotics do not work against viral infections, which cause most acute coughs, and so they may do more harm than good.

Duration You may easily suffer a dry cough for 3 to 4 weeks after an infection has settled.

Tests You don’t normally need any tests if you suffer from an acute cough.

What can I do myself to get better – now and in the future?

Try not to cough Although this may sound easier said than done, you may be able to cough less often by trying not to cough, because our desire to cough can sometimes be influenced by our brain.

Home remedies Try simple home remedies, such as ‘honey and lemon’ – just add freshly squeezed juice from one lemon and a teaspoon of honey to a mug of hot water. Drink at least 6 to 9 glasses of water in a day and suck lozenges.

Stop smoking Smoking is one of the commonest reasons for a chronic cough. Stopping smoking – or at least smoking less – not only improves your cough, but also benefits your health in other ways (reducing the risk of heart attack, stroke, and lung cancer, for example).

Cough mixtures There is little evidence to say whether over the counter medicines are effective for relieving cough symptoms. Despite the lack of research evidence, you may still get some subjective benefit from over the counter preparations – speak to your pharmacist.

Paracetamol Paracetamol can help with relieving symptoms that may accompany a cough, such as a sore throat, fevers, and not feeling well.

When should I seek medical help?

Seek medical advice immediately if you feel more unwell than you’d expect, if it starts after you’ve choked on something, or if you notice any of the warning symptoms below, which in rare cases can suggest a more serious underlying cause:

Coughing up blood You cough up blood for no obvious reason.

Duration Your cough is not getting better within three to four weeks.

Chest or shoulder pain In addition to your cough, you have chest and/or shoulder pain.

Breathlessness You also find it difficult to breathe.

Weight loss You’re losing weight for no apparent reason over a period of six weeks or more.

Voice changes Your voice becomes hoarse for longer than three weeks, and the hoarseness persists after the cough has settled.

New lumps or swellings You notice new swellings anywhere in the neck or above your collarbones.

Where can I find out more?

Check out NHS Choices (http://www.nhs.uk/conditions/Cough/Pages/ Introduction.aspx) or the Choose Well website (www.choosewellmanchester.org.uk/self-care) for more information on how you can treat and prevent cough. Remember that your pharmacist can also help you with assessing your symptoms.

Eczema:

This fact sheet helps you to know what’s ‘normal’ and what you can expect to happen if you

or your child suffer from atopic eczema (atopic means ‘sensitivity to allergens’). It also tells

you when you should become concerned and when it’s best to seek medical advice from a

health professional. When talking of eczema, we mean atopic eczema in this fact sheet.

Useful facts

What skin changes does eczema cause? If you suffer from eczema, your skin can

appear red (or darker, if you have dark skin), swollen, crusty and cracking. Itching

is common and often caused by skin dryness, infection, allergens or scratching.

How common is eczema? You’re not alone. Eczema is an often persistent or

recurrent dry skin condition, affecting about 2 out of 10 children and two to 10

out of every 100 adults in the UK.

What’s causing it? Eczema tends to start in childhood and is influenced by

genetic and environmental factors. People with eczema often suffer other

allergic conditions as well, such as asthma or hay fever, or both. Food allergy may

sometimes be responsible in children who present with more severe eczema

early in life.

What can I expect to happen?

How bad can eczema get? The severity of eczema can range from mild to quite

severe. Around eight out of 10 children have mild eczema, with episodic flare ups.

Will I get cured? Many children with eczema ‘grow out’ of it by the time they

reach adolescence. But in some people, eczema may persist life-long.

Fortunately, while there is no known cure, many effective treatments are

available to alleviate your symptoms and reduce inflammation.

What can I do myself to get better now and in the future?

Avoid trigger factors Environmental allergens (such as dust-mite antigens or

pollen), irritants (such as detergents or dirt), certain foods, pet dander, smoke,

certain weather conditions and stress may all impact on eczema. Try to find out

whether any of these impact on your eczema and minimise them.

Avoid soap Avoid soap and bubble bath, as both can dry out the skin. Use

emollients as soap substitutes.

Avoid scratching too hard Scratching is a natural reflex, but scratching too hard

can make the itch even worse (the ‘itch-scratch cycle’). So whenever possible,

avoid scratching your skin too hard with your fingernails – even if it’s tempting.

Instead, rub itchy patches gently with your fingertips.

Avoid temperature extremes Hot and cold temperatures may also make your

eczema worse. So dress appropriately for hot and cold environments, or try to

avoid temperature extremes altogether.

Use non-irritant garments Synthetic garments and wool can trigger eczema, so

you may prefer wearing clothes made out of cotton or other non-irritant

materials.

Moisturisers Eczema causes the skin to become dry, and the dryer the skin

becomes, the higher the chances that your symptoms will get worse. So try to

keep your skin as hydrated and smooth as possible by using your moisturising

creams or ointments regularly and liberally, even when your skin appears ‘clear’.

Inflammation and flare-ups Speak to your pharmacist about how you can step

up/down treatments. Antihistamines can help with itching.

Detergents Avoid using fabric conditioners and consider adding an extra rinse

cycle when using a washing machine.

When should I seek medical help?

Contact your GP surgery when you feel you need help. Rarely, eczema needs more

urgent assessment and treatment, so seek medical advice if you notice any of the

following:

Reduced quality of life Your skin problems severely affect your sleep or impair

social activities such as swimming.

Infection Cracking, weeping and painful skin may suggest infection.

Blistery rash You develop a painful blistery rash, which may be due to an

infection with the herpes simplex virus.

Spread Larger areas of your body, such as most of your chest, back, or limbs

become dry and/or red.

Where can I find out more?

There’s a lot you can do to relieve symptoms if your eczema gets worse. Check out

NHS Choices (http://www.nhs.uk/Conditions/eczema-

(atopic)/Pages/Introduction.aspx) and the National Eczema Society website

(www.eczema.org) as well as www.nottinghameczema.org.uk for further

information on how you can treat and prevent eczema. Remember that your

pharmacist can also help you with assessing and treating your symptoms.

Fever in Children:

This fact sheet helps you to know what’s ‘normal’ and what you can expect to happen if

your child develops a fever. It also tells you when you should become concerned and seek

advice from a health professional.

Useful facts

What is fever? Fever is a raised body temperature above the normal daily

variation, which usually suggests an underlying infection.

Fever is often ‘normalMild feverish illness is a normal part of childhood a

natural, healthy and harmless response to help the body fight infection.

Fever is common Between around 3 to 7 out of 10 pre-school children develop

at least one episode of fever every six to 14 months.

Common causes Common causes of fever include the common cold, ear

infections, stomach bugs (gastroenteritis), throat- and travel-related infections.

Serious causes Severe infections, such as pneumonia or meningitis, are in rare

cases the main cause of a fever.

Children under six months Any child under six months of age with a fever should

be assessed by a health professional.

What can I expect to happen?

Fever gets better by itself In most cases, fever is due to a common and harmless

illness that gets better by itself and your child won’t need antibiotics.

Duration Fever should not last for longer than five days.

What can I do to help my child now and in the future?

Check your child’s temperature In children aged between four weeks and five

years, use either an electronic or chemical dot thermometer in your child’s arm

pit, or an infra-red tympanic thermometer in the ear canal. If you haven’t got a

thermometer, use your judgement as to whether your child feels abnormally hot.

Clothing Avoid over- or under-dressing your feverish child.

Heating and cooling Keep your central heating down. Tepid sponging of children

is no longer recommended.

Fluids Offer your child regular fluids. If you’re a breastfeeding mother, offer your

child as many feeds as she/he will take.

Body checks Check your child at night for signs of serious illness (see over).

Schooling/nursery It is best to keep feverish children away from nursery or

school while the fever persists.

Medication You can give either paracetamol or ibuprofen if your child is unwell

or appears distressed. Neither should be given routinely just to reduce body

temperature or with the aim of preventing fits. Do not give your child

paracetamol and ibuprofen at the same time unless advised to do so by a health

professional. If you child is still distressed before the next dose of one of these

medicines is due, you can consider using the other.

When should I seek medical help?

Rarely, more serious medical problems may cause fever in children. Speak to your

child’s GP if your child’s health gets worse or if you have concerns about looking

after your child at home. Also seek medical advice straight away if you notice any of

the following:

High fever Usually defined as a body temperature over 38°C in children age 0-3

months or over 39°C in children age 3-6 months.

Vomiting Your child vomits repeatedly, or brings up dark-green vomit.

Skin colour Your child looks pale, ashen, mottled or blue.

Activity Your child doesn’t respond normally, wakes only with difficulty, is less

active, doesn’t smile, appears ill or cries in an unusual way.

Breathing Your child breathes much faster than usual. Your child’s nostrils flare,

and the skin between the ribs or the area just below the rib cage move

abnormally during breaths. You notice abnormal grunting.

Hydration Your child doesn’t eat or drink much and doesn’t pass as much urine.

Nappies stay dry, her or his mouth and eyes appear dry, or in babies, the soft

spot at the top of the head appears sunken or bulges.

Duration Your child’s fever has persisted for five or more days.

Rash You notice a new rash that doesn’t fade on pressure (press a tumbler

against the rash to see if it disappears).

Other signs Your child can’t walk for some reason and has developed a swelling

or new lump in a limb or joint. Your child has a stiff neck, cold limbs or has had a

fit. You notice any other unusual symptoms and signs that you can’t explain.

Where can I find out more?

Check out the NHS Choices website

(http://www.nhs.uk/Conditions/feverchildren/Pages/Introduction.aspx) for more

information on how you can manage fever in children.

Headache:

This fact sheet helps you to know what’s ‘normal’ and what you can expect to happen if you

develop an occasional headache. It also tells you when you should become concerned and

seek advice from a health professional.

Useful facts

Common types of headache The most common headache is tension-type

headache the one we think of as ‘ordinary’ or ‘everyday’ headache. Tension

headache tends to be mild to moderately severe and affects both sides of the

head. It usually feels ‘pressing’ or ‘tightening’ and is not affected by routine daily

activities. Migraine is a moderate or severe throbbing headache affecting one or

both sides of the head and made worse by ordinary daily activities.

Less common causes of headache These include cluster headache (a severe or

very severe pain around and above the eye), headache from overusing pain

killers (affecting about one to two out of 100 people), inflamed blood vessels,

and raised pressure inside the head (for example from a bleed or tumour).

Headaches are common As many as 8 out of 10 people have occasional tensiontype

headache from time to time, and 1 or 2 out of 10 people suffer migraines.

Migraine triggers Migraines can have many triggers, such as certain foods,

stress, hunger, tiredness and can get worse during menstrual changes or when

taking the combined oral contraceptive pill.

What can I expect to happen?

Rarely serious Although headaches can severely affect your life, they’re rarely

serious or life-threatening. Most get better by themselves, often within 24 hours.

Tests You won’t usually need further tests, such as scans or blood tests.

What can I do myself to get better now and in the future?

Headache diary Keep a headache diary and record how often you get

headaches, how long they last, and whether they are mild, moderate or severe.

This can be helpful to decide whether your headaches follow a particular pattern

and shows how they respond to treatment, which is useful when you need to

discuss them with a health professional. A useful online version for monitoring

migraine headache is available at http://www.migraineclinic.org.uk/wpcontent/

uploads/2012/01/NMC-monthly-diary.pdf).

Lifestyle Try to get plenty of rest and sleep, and use every opportunity to relax.

Diet and fluids Drink at least 6 to 8 glasses of fluid (ideally water) a day. Avoid

alcohol and take regular meals.

Pain killers Various pain killers are available without prescription from your

pharmacist. Choosing a preparation often comes down to personal preferences

and needs to take into account other medical conditions that you may have,

other medicines that you may be taking, and the risk of potential side effects.

Special migraine medications are available for treating migraine attacks. Avoid

taking painkillers for headaches for more than 10 to 15 days per month.

Other treatments Acupuncture can help with migraine and tension type

headache. Riboflavin (available as a food supplement from health food shops)

may help reduce migraine frequency and intensity in some people. Manual

therapy may help if you also suffer from neck aches.

When should I seek medical help?

Seek medical advice if over the counter treatments don’t relieve your symptoms, or

if you find it difficult to get on with your daily activities or go to work. Also speak to a

health professional if you notice any of the following:

Frequency Your headaches become more and more frequent.

Additional symptoms You vomit for no apparent reason or have a high fever.

You develop a stiff neck or feel drowsy.

After head injury You suffer from persisting headaches after a blow or other

injury to your head (though a mild headache for one to two days after a head

injury is common and usually harmless).

Sleep Your headache prevents you from getting to sleep or wakes you.

Certain situations Your headache is worse on coughing, straining, bending, lying

flat or laughing.

Speech and personality You notice a change in speech or personality.

Odd sensations You develop weakness, numbness or other odd sensations

anywhere on your body, or you feel unsteady on your feet.

Severity You develop a sudden severe headache, like ‘being hit with a hammer’.

Eyes Your eyes feel really uncomfortable when looking at bright light, or you

suffer other new eye symptoms, such as sudden blind spots.

Others symptoms You have muscle pains, pain on chewing, a tender scalp, or

feel unwell.

Where can I find out more?

NHS Choices (http://www.nhs.uk/conditions/headache/Pages/Introduction.aspx) and the

Pain Toolkit (www.paintoolkit.org) have more information on how you can treat and

prevent headache. Your pharmacist can also help you with assessing your symptoms.

Heartburn and Indigestion:

This fact sheet helps you to know what’s ‘normal’ and what you can expect to happen if you

suffer from heartburn or indigestion (also called dyspepsia). It also tells you when you

should become concerned and when it’s best to seek medical advice from a health

professional.

Useful facts

Dyspepsia is common You’re not alone. Symptoms in the upper abdomen may

affect up to 4 out of 10 people in any one year.

How does it present? Heartburn and indigestion are symptoms of pain or

discomfort in the upper abdomen or chest. They often result from overeating,

eating high fat meals or being overweight.

Timing Symptoms typically occur after meals.

Other problems Dyspepsia is commonly accompanied by belching, and feeling

bloated or sick.

What causes dyspepsia? Common causes include acid reflux from your stomach,

inflammation of the gullet, certain medicines (check the patient information

leaflet), infection with a bug called helicobacter pylori (or H. pylori), or when part

of the stomach squeezes through the diaphragm muscle into the chest (known as

hiatus hernia). Less commonly, a stomach ulcer or cancer of the stomach or

gullet may be responsible. Sometimes, no underlying cause can be found (this is

known as functional dyspepsia).

What can I expect to happen?

Duration Your symptoms will usually improve within one or two weeks. But if

you find that you keep taking indigestion medicines all the time for several weeks

or that your symptoms affect your day to day life, you need to consult your GP.

Effect of changing your diet In about 8 out of 10 people, symptoms will improve

by making lifestyle changes alone, such as healthier eating and losing weight.

Avoid fatty and fried meals, and eating large meals late in the day. Also try to

avoid carbonated soft drinks, coffee and alcohol. Eat slowly and chew properly.

Medication If lifestyle changes alone don’t work, you can expect your symptoms

to improve by taking over-the-counter (OTC) or prescribed medication.

Investigations Most people don’t need any tests. But if your symptoms aren’t

controlled, or your GP suspects a particular underlying cause, you may need

further testing. This may include looking into your gullet and stomach with a thin

and flexible tube-like camera (called endoscope) and blood or stool tests.

What can I do myself to get better now and in the future?

Smoking Reduce or stop smoking, which may help improve your symptoms.

OTC Medicines Various drugs that neutralise the acid in your stomach (antacids)

as well as other drugs called H2-receptor antagonists and proton pump inhibitors

(PPIs) are available without prescription over the counter at pharmacies, in

petrol stations and in supermarkets. It’s best not to take these medicines for

prolonged periods without consulting a pharmacist or other health professional.

Visit www.medicinechestonline.com for lists of medicines available without

prescription at pharmacies and other stores.

Avoiding aspirin-like drugs If you take OTC anti-inflammatory pain killers, such

as aspirin or ibuprofen, regularly, consult a health professional in case these

could be the cause of the indigestion.

When should I seek medical help?

Rarely, more serious medical problems may cause indigestion particularly if you

are aged 55 or over. Seek medical advice if your symptoms do not respond to

treatment or you notice any of the following:

Pain and other chest/stomach symptoms You suffer from severe, persistent

(longer than three weeks), worsening and unexplained pain in your upper

abdomen particularly if occurring together with other symptoms, such as pain

in your chest, breathlessness, sweating, feeling sick or vomiting.

Vomiting blood You vomit blood or dark lumps (like ‘coffee grounds’).

Dark stools Your stool colour has become very dark (looking like tar). But

remember that if you take iron tablets your stool can also become black a

harmless side effect which will go when you stop taking iron.

Feeling faint You feel faint, or you’ve collapsed.

Swallowing problems You develop difficulties with swallowing.

Other problems You suffer from unexplained fever, night sweats, weight loss for

no apparent reason, or you notice a swelling or mass in your upper abdomen.

Where can I find out more?

NHS Choices (http://www.nhs.uk/conditions/indigestion/Pages/Introduction.aspx) has

more information on how you can treat and prevent indigestion. Remember that

your pharmacist can also help you with assessing your symptoms.

Urine symptoms in men:

This fact sheet helps you to know what’s ‘normal’ and what you can do to help yourself if

you are affected by urinary symptoms, such as passing urine very often, getting up at night

more than once or twice to pass urine, a slow urinary stream, or having to rush to the toilet

a lot of the time. It also tells you when you should become concerned and seek advice from

a health professional.

Useful facts

How common are they? Many men develop problems with storing or passing

urine (urinary symptoms) as they get older. Up to half of adult men have some

urinary symptoms up to the age of 40, while almost two-thirds of men between

40 and 60 and over three-quarters of men aged over 60 are affected.

What causes them? Not all urinary symptoms are caused by the prostate gland,

although it is often blamed. Many men with urinary symptoms worry about

prostate cancer, but an enlarged prostate (called benign prostatic hyperplasia) is

much more common and the two are not linked. Diabetes can also cause

urinary symptoms.

Will I need treatment? Treatment for most urinary problems is aimed at

improving symptoms. So, if you’re not too concerned by your symptoms, you can

often manage them very simply by making a few changes to your lifestyle.

What can I expect to happen?

Duration: Most urinary symptoms are long-term and will either stay the same or

slowly worsen, unless they are caused by an infection.

What can I do to help myselfnow and in the future?

Keep a drink diary for a few days: Look at what you drink during a typical day. It

can be useful to keep a diary for a few days, making a note of:

o what you drink (for example tea, coffee, and water)

o the amount you drink (use a measuring jug or estimate the volume a

typical mug holds approximately 250mls)

o the time of day when you drink

Fluid intake: Aim to drink between 1500 and 2000mls per day. Many people

think that they need to drink large amounts of fluid each day for good health, but

this is untrue and will often make urinary symptoms worse.

Avoid stimulants: If you drink large amounts of tea, coffee, fizzy drinks or

alcohol, try cutting these down as they can increase urinary symptoms. Even

decaffeinated tea or coffee can cause problems, so try switching to mainly water,

fruit juice, squash or herbal teas and see how this impacts on your symptoms.

Avoid drinks before bedtime: If you wake during sleep to pass urine and you find

this troubling, look at your fluid intake before you go to bed. Try to decrease the

amount of fluid you drink in the hours before you go to sleep, and particularly

avoid tea, coffee and alcohol. This can make a big difference.

Massage: If you leak urine into your underwear after passing urine, this simple

technique may help: press upwards on the area between the sack containing

your testicles and your back passage after urinating and massage gently upwards

and forwards this can push out the last bit of urine and prevent leakage.

Bladder training: If you pass urine too frequently or have to rush to go to the

toilet, consider some simple bladder training techniques available at

http://www.patient.co.uk/health/overactive-bladder-syndrome.

Exercise more: Increasing your level of physical exercise and losing weight can

reduce urinary symptoms and also improve other aspects of your health.

Over the counter (OTC) products: Tamsulosin (or Flomax™) can help if an

enlarged prostate is causing a slow urinary stream. Avoid herbal medicines until

you’ve seen your doctor. Incontinence products help but are not the solution, as

your problems may be treatable. Your pharmacist and doctor can advise.

When should I seek medical help?

Contact your GP surgery for advice if you:

develop new urinary symptoms, particularly if they worsen quickly.

have cloudy or smelly urine, or if passing urine stings (this may suggest infection).

find your urinary symptoms troubling and OTC medicines don’t help.

see blood in your urine this can be a sign of bladder, kidney or prostate cancer.

leak urine (called incontinence).

have difficulty with erections this is common in men with urinary symptoms.

worry about prostate cancer, particularly if this runs in your family.

Where can I find out more?

To learn more, go to Patient.co.uk at http://www.patient.co.uk/health/lowerurinary-

tract-symptoms-in-men, Prostate Cancer UK at www.prostatecanceruk.org

and Your Prostate at www.yourprostate.eu for further information. To discuss any

problems with a specialist nurse, you can call a free helpline on 0800 074 8383.

Middle ear infection (acute otitis media):

This fact sheet helps you to know what’s ‘normal’ and what you can expect to happen if your child develops an infection of the space behind the ear drum (‘middle ear infection’, or acute otitis media). It also tells you when you should become concerned and seek advice from a health professional. Middle ear infection mainly affects children.

Useful facts

What is middle ear infection? Behind the ear drum is a small space that’s usually filled with air: the middle ear. To let air in and out, a small channel called the Eustachian tube connects this space to the throat. When germs (such as viruses or bacteria) enter during a cold, an ear infection can develop.

How dangerous is it? In most children, otitis media is a harmless infection that gets better by itself without any complications.

How common is it? Middle ear infection is very common, mostly affecting small children aged between six and 18 months. More than half of all children suffer at least one middle ear infection by the time they’re seven.

What are the symptoms? Older children usually complain of ear ache, while younger children often pull or rub their ears. Other common symptoms include runny nose, a raised body temperature (fever), being irritable, crying, sleep problems, cough and poor feeding.

Who’s affected? Middle ear infections are more common in children who breathe in tobacco smoke, attend day care (nursery,) or who drink formula milk rather than breast milk.

Does my child need antibiotics? Most children with a mild middle ear infection will not benefit from antibiotics. Antibiotics can be useful in children younger than 2 years who have infections in both ears, or who have an infection together with a leaking ear.

What can I expect to happen to my child?

Symptoms: Symptoms of middle ear infection tend to develop quickly and usually last an average of four days.

Fluid leaking from the ear: A hole may form in the ear drum and cause infected thick fluid (pus) to run out of the ear. This usually relieves the pain as it reduces the pressure on the ear drum.

What can I do to help my child – now and in the future?

Giving painkillers: You can give either paracetamol or ibuprofen if your child unwell or appears distressed. Neither should be given routinely just to reduce body temperature. Do not give your child paracetamol and ibuprofen at the same time unless advised to do so by a health professional. Instead, give the alternative medicine if your child does not respond to the first one you start with.

Keep your child cool: Avoid over- or under-dressing your feverish child. Keep your central heating down. Tepid sponging is no longer recommended.

Fluids: Offer your child regular fluids. If you’re a breastfeeding mother, offer as many feeds as she/he will take. Avoid dummies and feeding while lying flat.

Body checks: Check your child at night for signs of serious illness.

When should I seek medical help?

Most ear infections are not serious and get better by themselves. Contact your GP surgery for urgent advice if you notice one or more of the following:

High fever: A body temperature over 38°C in children age 0-3 months or over39°C in children age 3-6 months.

Not improving: Your child is generally unwell or doesn’t start to improve after four days.

Fluid: Fluid leaks out of the ear.

Other symptoms: Your child shows additional symptoms, such as being sick repeatedly, feeling dizzy, a stiff neck, a rash, slurred speech, confusion, seizures (fits), and/or being sensitive to light.

Where can I find out more?

Visit NHS Choices (http://www.nhs.uk/conditions/otitis-media/Pages/Introduction.aspx) or www.patient.co.uk for more information on what you can do if your child has symptoms of a middle ear infection. Remember that your pharmacist can also assist you in assessing your child’s symptoms.

Acute sinusitis (adults):

This fact sheet helps you to know what’s ‘normal’ and what you can expect to happen if you develop sinusitis. It also tells you when you should become concerned and seek advice from a health professional.

Useful facts

What are sinuses? Sinuses are cavities in our face bones that open up into the nose, helping to control the water content and temperature of the air reaching our lungs.

What is sinusitis? The body’s response to irritants or bugs (inflammation) can lead to sinusitis: a swelling and irritation of the lining of the sinuses. Viral infections, such as the common cold, can cause the lining of the nose to swell, blocking the small opening from the sinuses to the nose. Fluid inside the sinuses may build up, which can make you feel bunged up and stuffy.

What types are there? Sinusitis can be acute (resolving within 12 weeks) or chronic (lasting longer than 12 weeks).

What are the symptoms? The most common symptoms include a blocked or runny nose, pain and tenderness in the face, and a raised body temperature. Additional symptoms are headache, cough, pressure in your ears, feeling generally unwell, bad breath, tiredness, and reduced taste and smell.

Will I need antibiotics? The symptoms of sinusitis usually get better on their own without treatment. Antibiotics are unlikely to help unless the symptoms are severe (see over the page).

What can I expect to happen?

Duration: The symptoms of acute sinusitis last longer than the common cold and take about 2 ½ weeks to clear. Chronic sinusitis may last for months.

Need for treatment: In most people, sinusitis will get better without treatment, and about two thirds of people with sinusitis won’t need to see their GP.

Continued over the page FACT SHEET NO. 13

Produced by the Self Care Forum (www.selfcareforum.org). Last revised on 30 Oct 2013. Please contact Libby Whittaker 020 7421 9318 or email libby.whittaker@selfcareforum.org with comments or suggestions.

What can I do – now and in the future?

Simple measures: Rest, applying warm face packs and washing out the nose with a steady stream of saline solution (available from your pharmacy) may help relieve your symptoms.

Fluids and food: Drink plenty of fluids to replace those lost from sweating and a runny nose. Get some rest until you feel better – we usually know when we’re well enough to return to normal activities. Eat healthily, including at least five portions of fruit and vegetables every day.

Over the counter medicines: Paracetamol, ibuprofen or aspirin can help reduce the symptoms of sinusitis. Avoid giving aspirin to children under the age of 16 and follow the manufacturer’s instructions. A decongestant preparation for your nose (for a maximum of one week) can help if a blocked nose is the problem.

Not recommended: Complementary and alternative medicines, steam inhalation, and drugs such as antihistamines, mucolytics and steroids are currently not recommended. There is no convincing evidence that they work.

When should I seek medical help?

Contact your GP surgery for urgent advice if you notice one or more of the following:

 You develop a high temperature (above 39°C or 102.2°F), which can be a sign of amore serious type of infection;

 You’re confused or disorientated;

 You feel really unwell;

 You’re at high risk of complications because you suffer other medical conditions;

 You suffer severe pain or discomfort in your face;

 Your nose produces lots of thick green/yellow fluid.

Where can I find out more?

Visit NHS Choices (http://www.nhs.uk/Conditions/Sinusitis/Pages/Introduction.aspx) or Patient.co.uk http://www.patient.co.uk/health/Sinusitis-Acute.htm for more information about sinusitis. Remember that your pharmacist can also assist you in assessing your symptoms.

Sprains and strains:

This fact sheet helps you to know what’s ‘normal’ and what you can expect to happen if you suffer a sprain or strain. It also tells you when you should become concerned and seek advice from a health professional.

Useful facts

What is a sprain? Sprains are due to injured ligaments and often affect the thumb, wrist, ankle and knee. Typical symptoms of a sprain include pain around a joint, swelling, tenderness, and an inability to use the joint normally. Swelling often occurs almost immediately, whereas the onset of bruising may be delayed.

What is a strain? Muscle strains are caused by over-stretching or tearing of muscle fibres and are common in the legs and lower back – particularly in people who are unfit or do not use good sporting techniques. Muscle strains usually lead to muscle pain and swelling, bruising, and reduced limb function.

How common are they? Sprains and strains are common, but often go unreported. Ankle sprain is the most common type of sprain, often occurring during sports and resulting in 1 to 1.5 million Accident & Emergency (A&E) department visits in the UK each year.

What increases the risk of suffering a sprain or strain? You’re at higher risk of suffering sprains and strains if you don’t warm up properly when taking part in sport, or if you exercise when you’re tired.

What can I expect to happen?

How long will my symptoms last? Most sprains and strains get better by themselves and usually resolve within six to eight weeks, depending on where the injury is and how bad it is. This is opposed to a fracture – a broken bone – which usually requires medical investigation and treatment. You’ll find out later in this fact sheet which symptoms should prompt you to seek medical advice.

When will I be fit again? You’re likely to be able to return to full sporting activities at around 12 weeks. But some severe injuries of larger muscles may take several months to heal.

Will I need any tests? For most sprains and strains, you won’t normally need any X-rays or scans.

What can I do myself to get better – now and in the future?

PRICE Protecting the affected limb, resting it, and using ice, compression bandages and elevation (PRICE) are useful for treating injuries initially. Avoid heat, alcohol, running (or any other form of exercise) and massage (HARM) in the first 72 hours after an injury.

Exercises for sprains If you’ve suffered a sprain, gently move your limb in all possible directions (as soon as your pain allows) to increase and maintain flexibility. Avoid immobilising the affected body part – except in severe ankle sprains, where immobilisation can lead to a quicker recovery.

Rest for strains In strains, however, it’s beneficial if you keep the affected muscle still for a few days after the injury before starting to move it again. Do gentle stretching and strengthening exercises and wear appropriate footwear at home, at work and when you take part in sports.

Pain relief Painkillers and ointments are widely available over the counter (OTC)and can be used to relieve pain and reduce swelling. If you need help with these talk to your pharmacist.

When should I seek medical help?

Seek further medical advice if you’ve suffered a severe sprain or strain that may suggest a broken bone or joint dislocation, if your pain is not controlled by over the counter medication, or if your sprain or strain does not get better as expected. Warning symptoms and signs include:

Severity Your pain is severe and not controlled by OTC medication.

Duration Your symptoms don’t start to improve after three to four days of self-treatment.

Walking You can’t walk because of your injury, or an affected leg ‘gives way’ and makes you walk unsteadily.

Deformity The affected body part is deformed, or shows lumps or bumps.

Movement You can’t move an affected joint.

Numbness Your skin over the affected area feels numb.

Bruising and swelling You notice more than only mild bruising and swelling.

Where can I find out more?

Visit NHS Choices (http://www.nhs.uk/conditions/sprains/pages/introduction.aspx) or the Choose Well website (www.choosewellmanchester.org.uk/self-care) for further information on how to treat and prevent sprains and strains. Remember that your pharmacist can also help you with assessing and managing your symptoms

 



 
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