12 February 2018
Health and Wellbeing - Head, shoulders, knees and…
Make sure you’re fighting fit for work and play this 2018. We have enlisted the help of specialists from The Montefiore Hospital in Hove to bring you a top-to-toe health guide. There are self-help tips for eight common problems and advice on when to seek medical help.
Falling asleep over your desk because either you or your partner snores at night? Then it’s time to take action. If your Body Mass Index (BMI) is greater than 25, losing weight might help. Alter your sleeping position - use pillows to prevent you from rolling onto your back where you are more likely to snore; eat earlier in the evening and reduce alcohol intake particularly before bedtime; and stop smoking. Treat nasal problems like allergies effectively as this may be causing the snoring.
One in ten people suffer from sleep apnoea and may stop breathing for several seconds while they are sleeping. Seek medical advice if you regularly wake feeling very tried as sleep apnoea can affect blood pressure leading to increased risk of heart attacks or stroke. You may be referred to a specialist for further investigation. Solutions to reduce snoring include topical nasal medications and devices which move the jaw forward and widen the airways. Surgery is a last resort but can eliminate snoring for good. Mr Simon Watts, Consultant Ear, Nose and Throat Consultant Surgeon
Do you suffer with heartburn and embarrassing belching? It is a common problem caused by acid reflux and can also make you feel nauseous and make your breath smell. Reduce the symptoms by losing weight or stop smoking. Don’t rush your meals and avoid food triggers such as onions, spicy food, fizzy drinks and alcohol.
Try to leave at least three hours after a meal before going to bed and sleep with your head propped up at night. Take antacids, available from the chemist, within an hour of eating or as soon as symptoms occur. If symptoms continue, your GP may prescribe acid suppression tablets such as ranitidine and more powerful drugs called 'proton pump inhibitors'. You may be referred for an endoscopy to assess whether there is inflammation of the gut and to rule out other problems such as stomach ulcers or gallstones. Dr Khaleel Jamil, Consultant Gastroenterologist
Be Breast Aware
Lumps in the breast are not the only signs of cancer. Keep an eye out for: nipple discharge, painful breasts, a rash on the skin or skin puckering, if the nipple has become pulled in or looks different, a swelling in the armpit or around the collarbone. Examine yourself regularly, around a week after your period. This is easier in a bath when the skin surface is soft and slippery to allow the flat of your hand to glide in a circular motion whilst examining the different areas of the breast. Never squeeze the nipples to check for discharge.
The key message is, if it is not normal for you, then see your GP. You will be given an urgent referral to a local breast unit, although the vast majority of ladies referred don't have a diagnosis of breast cancer. Lynette Awdry, Hospital Matron and specialist breast nurse
You don’t have to play tennis to suffer with this condition which causes pain around the outside of the elbow. It’s most common in 30-50 years old and is due to repetitive use of the forearm muscles, either at work or during sport. You might find it painful to fully extend your arm or grip small objects such as a pen.
The first step is to rest your arm and take anti-inflammatories. Hold a cold compress against your elbow for a few minutes every day. Your GP may also prescribe a cortisone (steroid) injection. Alternatively, blood-based injections help repair the damaged tendon and may provide a longer lasting solution to the problem than cortisone. Physiotherapy may also be recommended. Surgery to remove the damaged part of the tendon is reserved for severe cases. Mr Joideep Phadnis, Consultant Orthopaedic Surgeon and Specialist Shoulder & Elbow Surgeon
Arthritis in the Hands
Osteoarthritis in the thumb is the most common form of arthritis that affects the hand, and women are more likely to get it than men. It is particularly common among manual workers, and symptoms tends to start in later life, around the age of 60-plus. The pain, stiffness and swelling extend to where the thumb joins the wrist and can decrease your grip strength and affect your ability to do even simple tasks like turning a door knob.
Dietary supplements such as Glucosamine and fish oils may help, and hand exercises can improve the range of movement. Ice the joint to ease pain and take anti-inflammatories such as ibuprofen. Your doctor may prescribe a steroid injection, or recommend a thumb splint which will help decrease pain, encourage the correct position for your thumb, and rest the joint, especially at night. For more severe cases, surgery includes replacing the thumb joint with a plastic joint to give flexibility. Mr Chris Williams, Consultant Orthopaedic Hand surgeon
Are you the one in 10 women affected by endometriosis, the commonest cause of pelvic pain? This disease causes heavy periods, and affects the bowel and bladder, making it painful to go to the toilet. And it can also reduce your chances of getting pregnant.
Often women put off going to the doctor because they think the symptoms are normal. It is also difficult to diagnose, and there is often a long delay between a woman going to a doctor about her symptoms and being diagnosed – up to six years on average. An ultrasound examination or laparoscopy, where a small telescope is inserted into the tummy, will confirm a diagnosis of endometriosis.
Regular exercise and switching to a healthy balanced diet can help. Treatments can include the ordinary contraceptive pill or progesterone hormone to help with pain. For women with moderate to severe symptoms, or who are trying to become pregnant, keyhole surgery usually offers the best results in terms of pain relief and enhanced fertility. Mr James English, Consultant Gynaecologist
Anyone who has ever experienced sciatica knows how agonising it can be and how it can impact on daily life, even affecting their ability to work (5 million working days a year are lost to back pain). Pain radiates down the lower back into the buttocks, back of the legs to the feet, and it can cause numbness.
It is due to compression of the sciatic nerve in the spine, most commonly caused by a prolapsed disc. In most cases, symptoms will improve with rest, painkillers and time. Use hot and cold packs on the lower spine and try stretching exercises. Avoid lying or sitting for too long as this can worsen the condition.
For persistent sciatica, a nerve root block, injected under X-ray guidance, can reduce the painful inflammation. If this doesn’t help, surgery may be necessary. This involves removal of the disc prolapse which is compressing the affected nerve root. It can be done minimally invasively and usually involves a one-night stay in hospital. Mr Shuaib Karmani, Consultant Orthopaedic Spinal Surgeon
A quarter of all UK workers suffer from painful knees and surprisingly it affects those who are desk-bound as much as it does those whose jobs involve heavy manual labour.
Years of poor posture while sitting at a desk increase the potential for knee pain. It starts with pain doing simple activities, such as getting out of a chair or going up and down stairs, but these are warning signs that action should be taken. First, address the position of your chair and desk to prevent you from slouching. Regularly do simple stretching exercises for your hamstrings and quadriceps muscles while sitting at your desk. Maintain a healthy weight to take pressure off the knees when standing. Avoid high impact sports and try yoga or Pilates to make your joints more flexible. Use ice and elevate your knee when possible to reduce the pain, and take anti-inflammatories. If knee pain persists, then physiotherapy and a consultation with a knee specialist to rule out other problems, is advisable. Mr Sandeep Chauhan Consultant Orthopaedic Knee Surgeon
Advice from specialists at The Montefiore Hospital, Hove, which was recently awarded an overall ‘Outstanding’ rating by the CQC.
First published in Sussex Business Times, January 2018.
29 January 2018
Useful self- help tips to ease the agony of sciatica
Don’t start the new year in pain with sciatica. There are steps you can take to help yourself and more that can be done to relieve the problem. Brighton and Hove Independent talks to Mr Shuaib Karmani, consultant orthopaedic and spinal surgeon at The Montefiore Hospital in Hove.
Anyone who has ever experienced sciatica knows how agonising it can be. It is more common in people aged 30 to 50 and can greatly impact on their daily life. Even simple actions like walking, sitting or driving can be painful. The pain radiates down the sciatic nerve from the buttocks, down the leg to the ankle, and can cause numbness and weakness in the foot.
The most common cause of sciatica is a prolapsed disc. In eight out of ten cases, symptoms will improve with rest, painkillers and time – usually between six to eight weeks. For persistent sciatica, an injection of cortisone (a powerful anti-inflammatory) around the pinched nerve can help. Called a `nerve root block’, it is administered under X-ray guidance and can reduce swelling and bruising. If this doesn’t help, surgery may be necessary. This involves removal of the disc prolapse which is compressing the affected nerve root. It can be done minimally invasively and usually involves a one-night stay in hospital. But the first step is to try these self-help tips. If you have sciatic pain for more than six weeks, your GP may prescribe stronger painkillers, recommend physiotherapy, or refer you to a specialist.
Self-help for sciatica:
- Use hot and cold packs on the lower spine regularly and try stretching exercises.
- Avoid lying or sitting for too long as this can worsen the condition. If you are sitting at a computer, adjust your chair to give good back support. Take regular breaks and go for a walk around the office.
- Use over-the-counter painkillers such as ibuprofen (check with your pharmacist if you are on other medication).
- Ensure to bend your knees and keep your back straight when lifting objects.
- When driving, especially long distance, take regular stretch breaks. Have your hands at ‘nine to three’ on the steering wheel to keep the sides of your trunk balanced. When not changing gear, keep your left foot on the rubber pedal (a feature in most cars) to allow both legs to be in the same position to maintain a balanced pelvis.
- When in bed, lie flat on your back with knees slightly bent. Place a pillow behind the knees for support. If you prefer to sleep on your side, place a pillow between your knees to prevent your back from twisting.
Mr Shuaib Karmani, consultant orthopaedic and spinal surgeon, holds clinics on Mondays, Thursdays and Fridays at The Montefiore Hospital in Hove. For more information call 01273 828 148.
First published in Brighton and Hove Independent on Saturday 20th January 2018.
26 January 2018
‘DON’T MISS OUT’ - Campaign hopes to stop fall in screening numbers
The number of women attending potentially life-saving smear tests has hit a 20-year-low in the UK, according to NHS figures.
The figures reveal that cervical cancer screening coverage fell from 72.7% to 72% in the last year with 1.4million women missing their tests.
Now cancer charity Jo's Cervical Cancer Trust is hoping to increase awareness with a SmearForSmear campaign, encouraging women who have taken their test to picture themselves on social media with part of their make-up smeared across their face.
It will run throughout Cervical Cancer Prevention Week from January 22 to 28 with the charity hoping that one woman’s post might just provide encouragement to other women and remind them of the importance of being screened.
At The Montefiore Hospital in Hove Consultant Gynaecologist Mr James English said: “The single biggest risk factor for developing cervical cancer is not being regularly screened. It is a preventable disease. The signs that it may develop can be often be spotted early and it can be treated before it even fully starts.
“While around 750 women each year die from cervical cancer in the UK, it appears that nearly one-and-a-half-million women a year are missing out on their tests1.”
Women aged 25 to 49 are invited to attend cervical screening, or smear tests, every three years; those aged 50 to 64 are invited every five years. The screening can detect abnormal (pre-cancerous) cells in the cervix in order to prevent cervical cancer.
Mr English said: “It is important to get the message across that cervical screening is not a test for cancer, but instead allows for detection of abnormalities at an early stage.
“The routine of attending a cervical screening should be an important part of every woman’s health regime but for many women this message just isn’t getting through. Early detection is key to increasing survival rates so educating everyone about the disease, its symptoms and ways to prevent it is very important.”
1 Figures from Office of National Statistics
15 January 2018
Charity of the Year 2018 – Forward Facing
We are pleased to announce that we have chosen Forward Facing as our Charity of the Year, who we will be helping to raise money in a number of ways throughout 2018.
Forward Facing offer activities for children and and young people with long term or life threatening conditions, or have experienced bereavement in the South East. These activities give the children a chance to transform themselves, to have fun, express their personalities and make lasting memories for them and their families. To find out more about Forward Facing and what you can do to help, visit: www.forwardfacing.co.uk