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Asthma is a condition that affects the airways – the small tubes that carry air in and out of the lungs.
When a person with asthma comes into contact with something that irritates their airways (an asthma trigger), the muscles around the walls of the airways tighten so that the airways become narrower and the lining of the airways becomes inflamed and starts to swell. Sometimes sticky mucus or phlegm builds up which can further narrow the airways. The illustration on the right shows a cross section of the airways, with and without inflammation.
All these reactions cause the airways to become narrower and irritated - making it difficult to breath and leading to symptoms of asthma.
Although there is no cure for asthma, there are some excellent medicines available to help you to control your asthma so that is does not interfere with your daily life.
It is important that you take your asthma medicine properly and that your doctor or asthma nurse has explained how to use inhalers properly so that every dose you take gives you the most benefit.
If your asthma is under control you are more likely to have a better quality of life and be more able to do the things you want to.
Signs may include:
This information, along with lots more, can be found on the website of asthma UK
Your asthma should be reviewed at least once a year by our Nurse Anne, even if you feel it is well controlled.
Also remember that if you use regular inhalers it is recommended you have the Flu vaccination. Further details will be on this website when this is available.
High blood pressure is one of several 'risk factors' that can increase your chance of developing heart disease, a stroke, and other serious conditions. As a rule, the higher the blood pressure, the greater the risk. Treatment includes a change in lifestyle risk factors where these can be improved - losing weight if you are overweight, regular physical activity, a healthy diet, cutting back if you drink a lot of alcohol, stopping smoking, and a low salt and caffeine intake. If needed, medication can lower blood pressure.
Blood pressure is the pressure of blood in your arteries (blood vessels). Blood pressure is measured in millimetres of mercury (mmHg). Your blood pressure is recorded as two figures. For example, 150/95 mmHg. This is said as '150 over 95'.
High blood pressure is a blood pressure that is 140/90 mmHg or above each time it is taken. That is, it is 'sustained' at 140/90 mmHg or above. High blood pressure can be:
However, it is not quite as simple as this. Depending on various factors, the level at which blood pressure is considered high enough to be treated with medication can vary from person to person.
A one-off blood pressure reading that is high does not mean that you have 'high blood pressure'. Your blood pressure varies throughout the day. It may be high for a short time if you are anxious, stressed, or have just been exercising.You are said to have 'high blood pressure' (hypertension) if you have several blood pressure readings that are high, and which are taken on different occasions, and when you are relaxed.
High blood pressure usually causes no symptoms. You will not know if you have high blood pressure unless you have your blood pressure checked. Therefore, everyone should have regular blood pressure checks at least every 3-5 years. The check should be more often (at least once a year) in: older people, people who have had a previous high reading, people with diabetes, and people who have had a previous reading between 130/85 and 139/89 mmHg (that is, not much below the 'cut off' point for high blood pressure).
High blood pressure is a 'risk factor' for developing a cardiovascular disease (such as a heart attack or stroke), and kidney damage, sometime in the future. If you have high blood pressure, over the years it may do some damage to your arteries and put a strain on your heart. In general, the higher your blood pressure, the greater the health risk. But, high blood pressure is just one of several possible risk factors for developing a cardiovascular disease.
Losing some excess weight can make a big difference. Blood pressure can fall by up to 2.5/1.5 mmHg for each excess kilogram which is lost. Losing excess weight has other health benefits too.
If possible, aim to do some physical activity on five or more days of the week, for at least 30 minutes. For example, brisk walking, swimming, cycling, dancing, etc. Regular physical activity can lower blood pressure in addition to giving other health benefits. If you previously did little physical activity, and change to doing regular physical activity five times a week, it can reduce systolic blood pressure by 2-10 mmHg.
Briefly, this means:
A healthy diet provides benefits in different ways. For example, it can lower cholesterol, help control your weight, and has plenty of vitamins, fibre, and other nutrients which help to prevent certain diseases. Some aspects of a healthy diet also directly affect blood pressure. For example, if you have a poor diet and change to a diet which is low-fat, low-salt, and high in fruit and vegetables, it can lower systolic blood pressure by up to 11 mmHg.
The amount of salt that we eat can have an effect on our blood pressure. Government guidelines recommend that we should have no more than 5-6 grams of salt per day. (Most people currently have more than this.) Tips on how to reduce salt include:
Caffeine is thought to have a modest effect on blood pressure. It is advised that you restrict your coffee consumption (and other caffeine-rich drinks) to fewer than five cups per day.
A small amount of alcohol (1-2 units per day) may help to protect you from heart disease. One unit is in about half a pint of normal strength beer, or two thirds of a small glass of wine, or one small pub measure of spirits. However, too much alcohol can be harmful.
Cutting back on heavy drinking improves health in various ways. It can also have a direct effect on blood pressure. For example, if you are drinking heavily, cutting back to the recommended limits can lower a high systolic blood pressure by up to 10 mmHg.
It is estimated that dietary and exercise interventions discussed above can reduce blood pressure by at least 10 mmHg in about 1 in 4 people with high blood pressure.
If you need medication your doctor or nurse will explain this to you.
If you are being treated for high blood pressure you need to have your blood pressure checked by one of our nurses at least every 6 months. You may need to be checked more often if it is not yet controlled sufficiently.
You will also need to have blood tests once a year to check your kidney function and cholesterol levels.
(information from patient.co.uk)
Cardiovascular disease, also known as heart and circulatory disease, covers all diseases that affect the heart and circulation. This includes conditions such as coronary heart disease (anginaandheart attack) and stroke.
Coronary heart disease is caused by a gradual build up of fatty deposits in the walls of your coronary arteries, which can then cause them to narrow. The medical term for this condition is atherosclerosis and the fatty material is known as atheroma.
Over time, the artery may become so narrow that it can’t deliver enough oxygen to your heart, especially when you’re exerting yourself. This can lead to angina – a pain or discomfort in your chest.
If a piece of this fatty material breaks away from the artery wall it can cause a clot to form, which will then starve your heart of blood and oxygen. This is known as a heart attack.
Angina is a pain or discomfort felt in the chest, and usually caused by coronary heart disease. However, in some cases the pain may affect some people in only the arm, neck, stomach or jaw.
Angina often feels like a heaviness or tightness in your chest, but this may spread to your arms, neck, jaw, back or stomach as well. Some people describe the feeling of severe tightness, while others say it’s more of a dull ache. Symptoms of experiencing shortness of breath have been reported too.
Angina is often brought on by physical activity, an emotional upset, cold weather or after a meal. Symptoms usually subside after a few minutes.
If your symptom pattern changes, you should speak to your doctor immediately.
Unfortunately you can’t reverse coronary heart disease, but you can help prevent your angina and the condition from getting worse by keeping your heart healthy. It is important to:
Some medications can also be used to help prevent angina episodes.
The symptoms of a heart attack vary from one person to another. They can range from a severe pain in the centre of the chest, to having mild chest discomfort that makes you feel generally unwell.
The common symptoms of a heart attack include:
The less common symptoms of a heart attack include:
If you suspect that you or someone else is having a heart attack, call 999 immediately.
If you have angina, or you have ever had a heart attack or coronary bypass operation then you need to have your blood pressure checked by one of our nurses every 6 months and you need to have blood tests at least once a year.
This and more useful information can be found on the British Heart Foundation website
Diabetes is a common life-long condition where the amount of glucose in the blood is too high as the body cannot use it properly. This is because the pancreas does not produce any or not enough insulin or the insulin that is produced doesn’t work properly (known as insulin resistance).
Insulin helps glucose enter the body’s cells, where it is used for energy. Glucose comes from digesting carbohydrate from various kinds of food and drink, including starchy foods such as breads, rice and potatoes, fruit, some dairy products, sugar and other sweet foods. Glucose is also produced by the liver.
Type 1 diabetes develops when the insulin-producing cells have been destroyed and the body is unable to produce any insulin. Usually it appears before the age of 40, and especially in childhood. It is treated with insulin either by injection or pump, a healthy diet and regular physical activity.
Type 2 diabetes develops when the body doesn’t produce enough insulin or the insulin that is produced doesn’t work properly. Usually it appears in people aged over 40, though in South Asian and Black people it can appear from the age of 25. It is becoming more common in children and young people of all ethnicities.
Type 2 diabetes is treated with a healthy diet and regular physical activity, but medication and/or insulin is often required.
The main symptoms of undiagnosed diabetes include passing urine frequently (especially at night), increased thirst, extreme tiredness, unexplained weight loss, genital itching or regular episodes of thrush, slow healing of wounds and blurred vision.
If you are having any of these symptoms please make an appointment with a nurse or doctor.
The main aim of diabetes treatment is to achieve blood glucose, blood pressure and blood fat levels (including cholesterol) within the target ranges agreed by you and your healthcare team.
This, together with a healthy lifestyle, will reduce the risk of developing the long-term complications of diabetes such as heart attack, stroke, amputation, blindness, kidney failure and nerve damage.
Although diabetes cannot be cured, it can be treated very successfully.
Type 1 diabetes is treated by insulin injections and a healthy diet, and regular exercise is recommended. Insulin cannot be taken by mouth because it is destroyed by the digestive juices in the stomach. People with this type of diabetes commonly take either two or four injections of insulin each day. If you have Type 1 diabetes, your insulin injections are vital to keep you alive and you must have them every day.
Type 2 diabetes is treated with lifestyle changes such as a healthier diet, weight loss and increased physical activity. Tablets and/or insulin may also be required to achieve normal blood glucose levels. There are several kinds of tablets for people with Type 2 diabetes. Some kinds help your pancreas to produce more insulin. Other kinds help your body to make better use of the insulin that your pancreas does produce. Another type of tablet slows down the speed at which the body absorbs glucose from the intestine. Your doctor will decide with you which kinds of tablet are going to work best for you and may prescribe more than one kind. Type 2 diabetes is progressive. If your diabetes cannot be controlled through lifestyle changes and tablets your doctor may recommend that you take insulin injections.
The main aim of treatment of both types of diabetes is to achieve blood glucose, blood pressure and cholesterol levels as near to normal as possible. This, together with a healthy lifestyle, will help to improve wellbeing and protect against long-term damage to the eyes, kidneys, nerves, heart and major arteries.
Monitoring your health when you have diabetes is crucial to preventing some of the complications associated with diabetes. This involves knowing your blood glucose, blood pressure and blood fat levels as well as the condition of your feet and getting your eyes screened for retinopathy
You will need to have blood tests at least every 6 months to monitor your blood sugar levels, as well as your cholesterol levels and kidney function. You will also need to bring in a urine sample once a year which is sent to the hospital to check whether there is any protein leaking from your kidneys.
You will need to have your feet checked at least once a year to test for pulses and nerve damage. You will need to have your blood pressure checked at least once a year, but more often if you have high blood pressure. These checks can be booked with Nurse Anne or a doctor.
You will be sent a letter each year to attend eye screening to make sure your diabetes is not affecting your eyes. If you have never received an appointment for an eye check please let the surgery know so that we can chase it up.
The surgery will send out reminder letters , but if you know that your reviews are due then please make an appointment to see us.
This and further information can be found on the Diabetes UK website
also known as 'chronic bronchitis' or 'emphysema'
Chronic bronchitis or emphysema can cause obstruction (narrowing) of the airways. Chronic bronchitis and emphysema commonly occur together. The term COPD is used to describe airways which are narrowed due to chronic bronchitis, emphysema, or both.
COPD is common. About one million people in the UK have COPD. It mainly affects people over the age of 40. It accounts for more time off work than any other illness. A flare-up (exacerbation) of COPD is one of the commonest reasons for admission to hospital.
Smoking is the cause in the vast majority of cases. There is no doubt about this. The lining of the airways becomes inflamed and damaged by smoking. About 3 in 20 one-pack-per-day smokers, and 1 in 4 two-pack-per-day smokers develop COPD if they continue to smoke. Air pollution and polluted work conditions may cause some cases, or make the disease worse. However, people who have never smoked rarely develop COPD.
Asthma and COPD cause similar symptoms. However, they are different diseases. Briefly:
Both asthma and COPD are common, and some people have both conditions.
A test called spirometry is often done to confirm the diagnosis. This test measures how much air you can blow into a machine.
If you you have some of these symptoms and think you may have COPD then please make an appointment with one of the doctors who can then organise for you to have Spirometry with Anne, if they feel it is appropriate. It is important to diagnose this condition early as treatment can improve your symptoms.
Stopping smoking is the most important treatment. No other treatment may be needed if the disease is in the early stage and symptoms are mild. You may be started on inhalers or tablets to improve your symptoms. The doctors or nurse will explain this to you.
Two immunisations are advised.
Studies have shown that people with COPD who exercise regularly tend to improve their breathing, ease symptoms, and have a better quality of life. Any regular exercise or physical activity is good. However, ideally the activity that you do should make you at least a little out of breath, and be for at least 20-30 minutes, at least 4-5 times a week. If you are able, a daily brisk walk is a good start if you are not used to exercise. But, if possible, try to increase the level of activity over time.
Carrying extra weight can make breathlessness worse
As for all chronic diseases, you should be seen by Anne or a doctor at least once a year for a review, even if you are feeling well. This is so that we can monitor your condition and optimise your care.
This information is on www.patient.co.uk
A stroke causes damage to the brain. Call for an ambulance immediately if you suspect someone is having a stroke (symptoms listed below). The common cause of stroke is a blood clot that forms in a brain artery. Immediate treatment may include a 'clot busting' drug to dissolve the blood clot. Other treatments include medication to reduce 'risk factors' for further strokes. Rehabilitation is a major part of treatment. Symptoms and disability following a stroke vary greatly depending on factors such as the part of the brain affected, how quickly treatment was given, and the extent of the damage to the brain.
Three simple checks can help you recognise whether someone has had a stroke or whether they may be having a TIA (Transient Ischaemic Attack):
Facial weakness- can the person smile?Has their mouth or an eye drooped?
Arm weakness- can the person raise both arms?
Speech problems- can the person speak clearly and understand what you say?
Time to call 999
For further information
For information about how you can try to reduce the risk of a stroke please follow this link. This information is available in several languages, including Spanish, Hindi, Bengali and Arabic
After you have had a Stroke and have been discharged from hospital and rehabilitation, it is very important to be regularly reviewed. We need to keep a check on your blood pressure and cholesterol level.If you are unable to get to the Surgery then we can arrange for a phlebotomist to visit your home to take blood and for a District Nurse to visit.
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