FAMILY PLANNING contraception

Contraceptive Advice  is available from all the doctors.  There are a number of methods  of family planning to suit all women.  We would be especially sensitive to the needs of young people, particularly confidentiality.   Emergency contraception “morning after pill” is best taken as soon as possible after the accident: In this practice, everybody can be seen the same morning, but if you are at work and cannot get here, please call to speak to a doctor on the telephone, or for 13-25y olds try certain chemists 

THE PILL HAS HAS TOO HIGH A FAILURE RATE  TO BE A SENSIBLE CHOICE FOR WOMEN NOT PLANNING ANOTHER CHILD IN THEN NEXT YEAR.

If you are taking the oral contraceptive pill, please remember to ensure you have your blood pressure checked by nurse every six months or ask a participating chemist to check it and let us know the result on your request slip. 
If you work, do visit one of the local Family Planning Clinics   They will also be able to fit coils which we cannot currently do for you, and run a HRT and Well Woman service.  Menstrual Reminders!

Unwanted Pregnancies
All the doctors find it very hard to deal with the situation where a woman falls pregnant, despite sensible contraception. We find it even harder when the woman has not taken up the offer of LongActingContraception, such as coils, implants, depo. We find it hardest when a few younger woman fall into the same trouble twice or three times.
We are a Christian practice and Abortion is against our principles.
We will however support the difficult decision of the individual woman who bears the responsibility of her choice, because an unwanted pregnancy may mean an unwanted child. 
Any women in such trouble should come and see their own GP as soon as possible (Dr Cockbain's patients should see another GP here) for a balanced discussion on what their options are.
A useful site is MarieStopes to get information on Early Medical Abortion, . BPAS.
Private companies will be advertising for your abortion. Advertising works! Look at what you're wearing. You have a choice, but that choice starts with using sensible effective contraception.

DOMESTIC VIOLENCE    0808 2000 247    AID    victim support=8685 1637

SEXUAL HEALTH

HelpLine 8407 3636  There is also a confidential genito-urinary (G.U.) walk-in clinic based at St.Heliers (self-referral) which deals with genital and pelvic infections and screens for sexually transmitted diseases.
8296 2543.   8296 2505    book appt  or Walk-in (Mon-Friday) 9-11.15am   
                                                                (can arrive & queue at 8.15am)  

StGeorges   Mayday

Chlamydia Screening our nurses offer this free service. We are a screening centre. Make an appointment and you'll simply be asked to produce a sample of urine, which we post off for you. FAQs  more...

THE MENOPAUSE

An increasing number of ladies in their 40's are suffering in silence with urinary incontinence, especially after child birth and weight increase. Please come and see GP for examination. Exercises with Aquaflex cones can prevent as well as treat the common condition.

Hot flushes can helped slightly by:
Agnus Castas
Soya Insoflavones
Black cohosh 20mg twice a day
Vitamin E  (200units/day)
Sage
none of which are on prescription. Or see doctor for a short-term trial of HRT (which has a small risk of causing Breast Cancer).

SMEARS
These should be done every 3yrs from age 25y.
if sexual activity started early, do discuss with doctor if you wish to have a smear before 25yrs age. smear  . Please book appointment with nurse. If you prefer, you can book with family planning clinics, see above.
If all smears have been normal, there is no need to have further smears beyond age 60yrs age.

PRE-MENSTRUAL TENSION     PMT

FERTILITY how do I know if I have a problem?

the science  Menstrual Chart   By carefully charting your periods, and noting other symtoms that might be associated with your cycle, your GP can get a better idea of how to diagnose and help you.

DiabetesUK

Usually, most of the food we eat is converted to Glucose (sugar) in the blood.  The body produces insulin which stores this Glucose. The amount of Glucose circulating in the blood should be kept down this way, by storing it away.  Diabetes is a condition where either the body stops producing insulin (in which case, we replace it with manufactured insulin), or the body becomes resistant to the effects of the body’s own insulin, in which case we give tablets to help store the glucose away.

Avoiding sugary foods also helps keep the Blood Glucose level down to the normal 4 to 7.

If one is sick, usually the Blood Glucose level rises. 
         So it is important to keep on with the tablets.

If one isnt eating, it is better to slightly  reduce the tablets
        (or insulin injections, if you are on them).

Driving the Blood Glucose level too low, by not eating enough, can cause a ‘hypo’ which can make you faint. In which case, a sugar cube is always a useful thing to have around.

Testing the urine with Diastix is a way of seeing how much Blood Glucose is: the amount of sugar in the urine (brown test result) usually mirrors the level of Blood Glucose. This is suitable for most Diabetics not taking Insulin.

For those diabetics taking insulin,  testing the blood by finger prick is much more accurate. Generally, a Blood Glucose of over 15 is dangerous!. Ideally it should be under 7.

If you're readings are reasonable predictable, there is no need to test 2-3 times per day out of habit. Do come and show doctor/nurse Khristyne your log book for more strips.

The PCT health authority has recommended we change monitors to GlucoRx because some of the other meters strips cost up to £25 per box of 50. Marketing causes overpricing. GlucoRx strips cost £10 per box. All the local chemists have been instructed. You ought to be able to buy a meter for £15, as a one off cost to you. If you have any difficulties, the chemist or Khrystine here will be able to help.

Driving   you must inform your insurance company and DVLA

Diet   is important.  Foods with high Glycaemic index  release the sugar too quickly and so will drive up your blood sugar too quickly. What goes up must come down. So you are left with a blood sugar that spikes up and down all the time! asian diet

If you require any vaccinations relating to foreign travel you need to make an appointment with the nurse Ivy Lim to discuss your travel arrangements.  This will include which countries and areas within countries that you are visiting to determine what vaccinations are required.  Flying after ops.

It is important to make this initial appointment as early as possible  - at least 6 weeks before you travel - as a second appointment may be required for those vaccines which are not a stock vaccine.  Your second appointment needs to be at least 2 weeks before you travel to allow the vaccines to work.

Some travel vaccines are ordered on a private prescription and these incur a charge over and above the normal prescription charge.  This is because not all travel vaccinations are included in the services provided by the NHS.

Yellow Fever   vaccination and certificates are not done here. We would advise that you contact RobinHood Lane private Travel Clinic 8254 8100  8254 8101 or search

Don't forget Travel Insurance (in Europe the free card will not fully cover you)

There is further information about countries and vaccinations required on the links below

Europe & Russia	North America
Central America	South America
Carribean	Africa
Middle East	Central Asia
East Asia	Australasia and Pacific

Nurse Ivy Lim runs an Asthma Clinic appointments which you can fit into her general surgery, for your convenience.

Asthma is the temporary narrowing of hypersensitive airways due to inflammation.
Inflammation (which is like the swelling in your thumb if you bash it!) can be triggered by things that you are allergic too. Salbutamol (blue puffer) temporarily relieves asthma by temporarily opening up the airways.  But if you find you are using the Reliever more than 3 times a week, then you should take a preventor (Clenil) everyday. The preventor reduces inflammation around the airways.

Hyperventilation though it isn't the whole story, lots of people (including asthmatics) take very frequent shallow breaths, rather than long deep breaths. This gives a restricted feeling. Sometimes it can even give tingling in the hands! Learning to breathe properly can help some asthmatics, even 'cure' what was initially thought to be asthma  trainer  Do check with GP before use.

Allergy  in some asthmatics, the temporary narrowing (constriction) of the bronchi (airways) can be triggered by cats,dogs, house dust mites. This can be seen in the nose in the way of redness and polyps: a nasal spray may help.

Fitness improving your general fitness level will help your asthma. There are some asthmatics who only wheeze with exercise, and only take a blue Reliever before starting to exercise. But fitness is nethertheless important.

Annual Checks
We are obliged to check your asthma at least once a year. Often, people put up with their symptoms, or just put their breathlessness down to being unfit. Do book an appointment with the nurse. Or at the minimum, download our questionnaire  and drop it by. We will not be able to do prescriptions if an annual check is not done.