Monkeypox Statement

30.05.2022 Category: General Health Author: Dr Richard Dawood

With monkeypox cases being recorded in over 20 countries across the globe, people are becoming increasingly concerned about its spread and transmission.

Following 2 years of the Covid-19 pandemic, this outbreak has reignited the public’s fear and uncertainty of infectious diseases. 

Whilst the media coverage of the monkeypox outbreak is alarming, we would like to reassure our patients that as it stands, the risk is still very minimal and vaccination is not advised as a precautionary measure. Whilst vaccines will undoubtedly be a key part of containing the outbreak, for now, only people who may have been exposed are being offered vaccination.

Our Medical Director & Travel Medicine Specialist, Dr Richard Dawood explains;

“Lots of people have been getting in touch with us to ask about a monkeypox vaccination, but this is not available privately. It is currently only being offered to anyone identified as a direct, close contact of a confirmed case deemed to be at sufficient risk.

The current outbreak does, however, highlight the need to think about your vaccine protection more generally, whether for travel or simply to protect your health and well-being, taking advantage of the best vaccines currently available.”

In a more general sense, it is never too late to catch up on childhood vaccinations, incomplete vaccination courses or any required boosters.

Your immune system naturally decreases with age and certain diseases are also more prevalent in older adults so there may be new vaccinations which are now suitable for you to consider for preventable diseases. Some health conditions can also weaken the body’s immune response, making you more vulnerable to infectious diseases, complications and hospitalisation. Therefore, it is important to ask your GP which vaccinations would be suitable for keeping you healthy.
 – For more information on wellness vaccinations.

If you are travelling soon and haven’t had a travel consultation with a travel nurse, perhaps it is time to consider one. Travel nurses are experts in travel health and will advise which travel vaccinations & medications you should consider based on the risk of where you are travelling to and your itinerary once there.
– For m
ore information on travel consultations.

To conclude, we’d like to dismiss a couple of dangerous myths about monkeypox that are unnecessarily scaremongering the public:

Myth 1: Monkeypox is as contagious as COVID-19 or smallpox

Fact: Monkeypox is far less contagious compared to smallpox, measles, or COVID-19.

Myth 2: Monkeypox is a new virus.

Fact: No, the monkeypox virus is not a novel virus. It’s a known virus and is generally seen in central and western African countries as localised outbreaks.

In summary, we, like the rest of the medical field, will be keeping a close eye on the progression of the Monkeypox outbreak and should our advice change based on new information, we will update this statement accordingly.

 

For more information on Monkeypox.

Can acupuncture help with chronic stress?

06.04.2022 Category: Acupuncture Author: Diane Timewell

Everyone lives such busy lives, so much so that stress now seems an inevitable part of daily life. Whether it be work, personal relationships or even keeping up hectic social schedules, there is often very little time to truly relax.

When stress is chronic it will affect the body in many different ways, interfering with normal body functions such as digestion, blood flow, your pain threshold and also your ability to sleep. Your risk for depression and anxiety, heart attack and heart disease, obesity, eating disorders, and several gut problems also increases. 

Tension across the shoulders, headaches, short temperedness, insomnia, tiredness, aches and pains, digestive disorders or menstrual problems are all made worse when the body is stressed and chronic stress can often be the root of unexplained infertility.

Common effects of chronic stress could include the following. 

  • Upset stomach, diarrhoea, nausea, constipation, heartburn, or other gut issues
  • Rapid heart rate or chest pain
  • Trouble sleeping
  • Loss of sexual desire or reduced sexual function
  • More colds or seasonal illness than usual
  • Clenched jaw or teeth grinding
  • Sore, tense muscles, especially in the neck and shoulders
  • Constant worry
  • Always seeing the “worst case scenario”
  • Racing thoughts
  • Feeling frazzled and unfocused
  • Disorganisation and forgetfulness

Can you spot any of your mental or physical symptoms in the list?

So how does stress impact the body?
When subject to a stressor, adrenaline floods the body and primes the muscles and senses ready for action. Whilst this is useful to escape from danger, to meet that important deadline or to win the 100m race, when this ‘fight-flight’ stress response is constantly switched on, prolonged muscle tension and poor circulation eventually take its toll on the body. Often resulting in poor health, fatigue and ultimately adrenal exhaustion and collapse.

Our acupuncture specialist, Diane Timewell runs our acupuncture clinic in London. She takes a particular interest in the effects of chronic stress and how acupuncture can help with switching the body from this ‘fight- flight’ response into the parasympathetic ‘rest and digest’ side of the nervous system. Acupuncture can help with controlling stress and anxiety, as it affects the part of your brain that regulates emotions, reducing stress naturally.

Medical acupuncture stimulates acupoints of the body to promote the release of ‘happy hormones’ such as endorphins. This reminds the body to relax, let go of daily stress and signals that you are safe and secure so the stress response can be turned off. In doing so, proper circulation is restored allowing our internal organs to work as they should unhindered by tension. This produces a vibrancy and vitality that can be felt both physically and mentally. 

When it comes to acupuncture treatment for stress, there is no one-size-fits-all approach. Whilst there are many points that consistently improve stress, when acupuncture is used to treat stress, the treatment will be fully bespoke. 

Stress affects everyone’s body individually and so Diane will work with you to pinpoint all your personal imbalances, treating your whole body based on your particular symptoms and pain areas.

You don’t need to feel unwell to benefit from acupuncture medicine. High achievers, Type A personalities, those who want to climb every mountain are very often sympathetic-dominant adrenal types. Adrenaline is the motivator of the body and so to some extent all successful people will benefit from a certain amount of stress. Learning how to switch it off after the target has been achieved is the key. 

Acupuncture treatment is an essential tool for both physical and mental well-being. It can be an excellent way to learn how to take control of your health and switch off chronic stress.

At Diane’s acupuncture clinic, she creates a safe and peaceful environment where you can de-stress, reenergize and regain your natural well-being and vitality.

You can book an acupuncture appointment with Diane online.

Chronic kidney disease (CKD) & Diet

08.03.2022 Category: Dietitian Author: Ruth Kander

Chronic kidney disease (CKD) is a long-term condition where the kidneys don’t work as well as they should. In some circumstances, the loss of kidney function can get progressively worse over time but CKD only reaches an advanced stage in a small proportion of people. Although the damage is irreparable, sometimes if changes are made, CKD can be halted with no further damage occurring.

Chronic Kidney disease (CKD) is divided into 5 stages.
Stage 1 is the earliest stage whereby tests have indicated some level of kidney damage. It is important not to ignore a stage 1 diagnosis as this is the time to take action and make lifestyle changes so that the condition does not worsen. With every increase in stage, more kidney damage has been detected up until the last stage, stage 5. Stage 5 means the kidneys have lost almost all their function and it will be time for thinking about dialysis or a transplant.

What to do if your recent blood test shows a reduced kidney function.
Don’t panic, absorb the diagnosis and understand this doesn’t definitively mean your kidneys will stop working altogether. CKD should not be ignored as it can get worse over time but with careful monitoring and management it can be maintained and you can live long fulfilling lives without being unduly affected by the condition.

It is important to review your lifestyle and in particular, your diet. With early stage CKD (stages 1-3) it is paramount to be as healthy as possible and have a healthy balanced diet.

What do  I mean by a healthy balanced diet?

This includes: 

  1. Consistently eating freshly cooked food for every meal
  2. Limiting your intake of processed foods and avoid highly-processed foods
  3. Reducing your daily salt intake
  4. Having considered balanced meals – your lunch and dinner meals should contain proteins, carbohydrates and vegetables. Your portion size will depend on your  weight and if you have diabetes
  5. Ensuring you have a minimum of 2-3 portions of fruits and vegetables each and every day
  6. Increasing your intake of plant based proteins such as beans, lentils, tofu, soya, seitan 
  7. Drinking lots of water to remain well hydrated (ensure your urine runs clear)
  8. Being as active as physically possible for you
  9. Avoiding non-steroidal medicines such as ibuprofen, naproxen etc.

What is a renal diet?
You may have heard of the term, renal diet. The term is used quite widely amongst those who have CKD, but personally, I am not a fan of this term. It doesn’t really mean much and can often be misused. People often think it means a diet of low protein, low salt, low potassium and low phosphate – which is pretty hard to do all at once and not always necessary. 

People newly diagnosed with CKD in particular often restrict their diet in a panic unnecessarily and in combination with online resources not being clear enough, this can cause a lot of confusion.

My advice would be to seek guidance from someone like myself, a dietician who can look at your lifestyle and individual health and work out a personalised diet plan. This will be much more achievable and as well as not feeling so overwhelming, you’ll only have to limit the foods you absolutely need to.

How do you monitor CKD?
The best way to monitor CKD is to have regular tests, either blood or urine. How often you require testing will be dictated by the stage of CKD. Your GP will determine what is best for you and it is best to ask them any medical and testing questions rather than your dietician who will focus solely on your lifestyle and diet.

______________

Ruth Kander is a kidney-specialist dietitian, to book an appointment with her please click here.

Taking Women's Health Seriously

07.03.2022 Category: General Health Author: Dr Belinda Griffiths

Women today lead incredibly busy lives. They run and organise homes and build successful careers, usually all whilst taking on the majority share of caring for their children and often their older relatives. It is therefore not uncommon for women to have little or no time to look after themselves, their health included.

In addition to not making time to prioritise their health, it seems that when women do put their health first and seek medical advice, they are less likely to feel heard and supported in comparison to their male counterparts.

A recent survey by The Department of Health and Social Care found that “more than 4 in 5 (84%) women they surveyed had experienced times when they (or the woman they had in mind) were not listened to by healthcare professionals.”

Based on the data they collected, ‘not being listened to’ appears to be present at all stages of the healthcare pathway. Specifically, many women told them: 

  • their symptoms were not taken seriously and/or dismissed upon first contact with GPs and other health professionals 
  • they had to persistently advocate for themselves to secure a diagnosis, often over multiple visits, months and years 
  • if they did secure a diagnosis, there were limited opportunities to discuss or ask questions about treatment options and their preferences were often ignored

Many women recalled their symptoms being dismissed upon first contact with GPs and other professionals; women felt they had to persistently advocate for themselves to secure a diagnosis, often over multiple visits, months and years; and post-diagnosis, discussions about treatment options were often limited, and some said their preferences were ignored. 

To make matters worse, there is some evidence that due to historical clinical trials being disproportionately male-orientated there is much less research into women-only health concerns and assumptions have been made that similar medical treatments will work for both sexes. The top reasons for the under-representation of women in trials were the belief that hormone fluctuations could influence results and concerns that fertility could be affected. A widely accepted negative repercussion, amongst others, being that women are much more likely to experience adverse side effects of medications because drug dosages have historically been based on clinical trials conducted on men.

A combination of these factors may explain why there is a gender gap in health outcomes, with women experiencing poorer health outcomes in comparison to men. We strongly believe in equality and ensuring health is a top priority for all.

Therefore, here are the top health symptoms women should never ignore:

1) Any change in bowel habit and/ or urination

This includes blood in the stools, unexplained persistent abdominal pain, weight loss, lumps around the anus, lack of appetite, blood in the urine or increased frequency of urination. These are all reasons for seeing your doctor ASAP as these symptoms could be due to bowel, bladder or ovarian cancer. All patients should have an annual faecal occult blood (FOB) test to exclude bowel cancer, which has increased in incidence in the UK for reasons unknown. Or if you are looking for a more in-depth investigation, you should request a colonoscopy which entails looking at the bowel with a colonoscopy. This is the gold standard, but an FOB is the next best thing and far less invasive as a first investigative option. It takes no time at all and is a good preventative check.

​​2) Any changes to the breast.

Any breast lumps, skin changes, nipple discharge, nipple changes or pain in the breast must be checked ASAP. Breast cancer is the most common type of cancer in the UK and often can present insidiously. Get to know what your breast feels like so that any subtle changes can be detected as early as possible.

3) Skin lesions that do not heal.

Any scab on the skin which does not heal, especially around the eyes, nose, ears and face should be checked. All these areas are the most sun-exposed, and, as such, are more at risk of skin cancer. If these lesions are picked up and treated early, scarring is minimal, but if left, then disfiguring scars and skin grafts may be necessary.

4) Bleeding after the menopause.

If you experience any bleeding after 1-year of your last menstrual period, you must visit your GP for further investigation. Bleeding after the menopause is not common and could be an indicator of cancer of the uterus, or the cervix. They will usually opt for a biopsy of the uterine lining to exclude both – don’t worry, this doesn’t hurt.

5) Always have regular cervical screens. 

Most people don’t find cervical screens painful, although they can feel somewhat uncomfortable. If you are concerned about the pain or you have previously found the procedure painful with the NHS, you can opt to book a private appointment. It is important that you don’t miss your appointment. 

6) Bleeding between periods.

At any age, you should never ignore bleeding between periods or after intercourse, as this can be a sign of cervical or uterine cancer. Whilst cervical cancer is monitored by regular screening, it is important to still get bleeding between periods checked out following a normal smear result. Cancer of the endometrium is becoming increasingly common in women who have not had children.

7) A persistent cough.

Regardless of gender, you should get a persistent cough checked out by your doctor, especially if you are coughing up discoloured sputum or blood.

8) Any unexplained changes to your body.

Any new indigestion, shortness of breath on exertion, neck or left arm pain requires follow up ASAP. Make sure a GP examines your chest and makes the appropriate investigations.

The same applies to calf pain or any pain in the chest. By taking a full history, examining you and doing quick and easy investigations, worrying conditions can be excluded, such as a pulmonary embolism or a heart attack.

Some recent examples of cases where other healthcare providers have failed our new female patients:

1) We saw a 36 year old who had not had a cervical screening for 5-years because the last one was so painful. The NHS advises a screening every 3-years but we advise yearly screenings to ensure any abnormalities are found as early as possible. 5-years is far too long!

2) We saw a woman who had a suspicious lump at her anal margin, which her usual GP had told her was part of her bladder. She wanted a second opinion because it had grown in size and was now painful. The patient was referred for an urgent assessment to exclude cancer.

3) We saw an 88 year old patient who was disfigured by a large basal cell carcinoma on her forehead, about which she was embarrassed. The patient had been seen by a dermatologist who had frightened her about having the lesion removed by saying she might not survive an anaesthetic. The patient wished that she had taken the risk and asked to be referred back, as the skin lesion was disfiguring and ruining her quality of life.

** The outcomes of these patients are yet unknown, but they are all certainly serious health concerns that should have been properly addressed long before now. 

We want to encourage women to take ownership over their health and be assertive when they feel that something has changed from our normal. If they feel like they are not being taken seriously or not being heard, they should seek a second opinion. 

If you cannot get an appointment with your usual GP or through the NHS, rather than waiting  for weeks and worrying about what it could be, make an appointment with a private GP who can usually see you on the same day! 

Put your mind at ease with private healthcare.

How to calm your flight anxiety before you fly

04.03.2022 Category: Travel Health Author: Lucy Mildren

Fear of flying, otherwise known as aerophobia, is an excessive worry about air travel. It is one of the most common forms of phobia and according to YouGov, around 24% of Brits have some form of anxiety about getting on a plane.

People suffering from fear of flying experience extremely anxious thoughts which are often so powerful they become physical symptoms. These can include shallow breathing, experiencing chest tightening, sweaty palms, feeling nauseated or lightheaded and sometimes these even develop into a panic attack, meaning many opt to avoid air travel altogether. 

For some, it will have been a lifelong problem that has meant never flying at all. For others, who have flown many miles in their lifetime, it is a problem that slowly creeps up on them over time. In both circumstances, the fear can be debilitating and symptoms often trickle into other areas of life. 

Like all phobias, there is little logic to support the anxiety that it causes – travel is in fact the safest form of transport and you are much more likely to die from a car accident than in a plane crash. Knowing that fact does little to ease the flying-related anxiety of an aerophobic sufferer. 

So, what can be done to overcome our fear of flying? 

Understand the reason why you’re a nervous flyer
Fear of flying is usually caused by a combination of factors. Understanding the root cause of your own phobia is perhaps the first step in overcoming it. Is it a fear of heights? Claustrophobia? Was it that film you watched as a child? Or has a particular world event sparked the fear? Many people suddenly developed a fear of flying after 9/11 for example. Figuring this out will then allow you to tackle it in the right way and using the appropriate techniques. 

Fight fear with knowledge
Some experts suggest the first strategy for everyone suffering from a fear of flying is learning about the aeroplane and the science behind flight. Our anxiety is fed by ‘what if?’ catastrophic thoughts. Once you become knowledgeable, your ‘what if’ thoughts will be limited by the facts. There are professionally designed courses that will explain aspects like air traffic control, anti-terrorism measures, and what happens during turbulence. Some courses use Virtual Reality (VR) to simulate a flight, explaining everything along the way with the aim of injecting logic into an illogical fear. 

Seek medical help for anxiety, fear and panic
From here, a form of therapy may help to identify and break anxiety cycles. There are many different types of therapy and choosing the right one for you will depend on your own needs and goals. Hypnotherapy and cognitive behavioural (CBT) are some of the most commonly used, but there are countless more to choose from. Deciding which is the most appropriate form of therapy can be daunting, so it may be helpful to seek advice from your GP or a travel nurse. 

For those who manage to make it onto the plane, there are quite a few, simple personal techniques that can be used to calm your nerves. 

Deep breathing techniques
Making a conscious effort to breathe slowly and deeply can interrupt panic. Deep breathing is known to trigger a comfort response and will help prevent hyperventilation. 

Distract yourself
Reading a book or listening to a good podcast can refocus your mind and attention.Distracting yourself from the fact that you are flying can be a great way to keep calm if you’re a nervous flyer.. Time tends to pass much more quickly when adequately distracted. 

Tell the flight attendants
Alerting the flight attendants of a nervous flyer could also help – with their training and expertise, they are ideally placed to provide reassurance and will regularly check in on you during the flight. 

Avoid coffee and wine
Nervous flyers in general should avoid drinking coffee and wine before and whilst flying. Both can leave you more dehydrated than normal. The extra caffeine in coffee can aggravate anxiety issues and the Dutch courage wine offers will pass leaving you more susceptible to jet lag. Stick with water where possible. 

Tea really does help
It’s very British to recommend tea to make everything better, but there are many different herbal teas available which can help with relaxation, reducing stress and calming anxiety. Peppermint, camomile, lemon balm and lavender teas are the most commonly used.

We advise nervous flyers and people with aerophobia to seek further information and guidance from their GP who will be able to make a formal diagnosis and treatment options.

For more advice and information you can book a travel consultation appointment.

How to avoid fragility as we age

03.03.2022 Category: General Health Author: Dr Belinda Griffiths

Ageing is an inevitable part of living. As we age, many physical and psychological changes affect our overall health and these vary from person to person.

The general myth is that as you age, you become more fragile and that this is unavoidable. This is most certainly not the case. There are always things we can do to help keep healthy in our older years and these changes can slow down or even prevent certain health conditions from developing.

The term “fragile” is defined as not “strong or sturdy; delicate and vulnerable” and is most often used to describe older ladies. One particular age-related health issue that supports this description would be osteoporosis. 

Osteoporosis is a degenerative disease that weakens and thins the bones which makes them fragile and more likely to break and is becoming increasingly common. It is much more prevalent in women than men due to the menopause directly affecting hormone balances and this directly affects bone density. It is important to prevent osteoporosis as we age as 75% of fractures due to osteoporosis occur in people aged 65 and over. 

There are several things you can do to help prevent osteoporosis:

1) Do regular, weight bearing physical activity.
The lack of regular exercise will result in loss of bone and muscle, so adults who are inactive are more likely to have a hip fracture than those who are more active. Adults should aim to do at least two and a half hours of moderate-intensity exercise every week. Weight bearing and resistance training are a particularly great way of improving bone density and helping to prevent osteoporosis. 

2) Eat plenty of calcium and Vitamin D containing foods.
Your diet is very important and the nutrients we get from the food we consume will affect how strong our body is. Eat plenty of dairy, seeds, eggs, oily fish, protein, fruit and vegetables. Additionally, try to get at least 15-minutes of sun exposure per day to increase your Vitamin D intake. As we know in the UK, such sun exposure is not always possible during the winter months and, if this is the case, taking a daily Vitamin D supplement is advised. 

3) Maintain a healthy weight.
As you get older, you start to lose lean body mass like muscle and bone density and this can start to happen yearly from the age of 30. Being underweight weakens your bones so it is important to keep your weight in a healthy range. A good indication, although not exact, is your BMI. For most adults, a healthy BMI range is between 18.5 and 24.9, so try not to let your BMI fall below 19.

Those who suffer from eating disorders such as anorexia and bulimia are at a higher risk of fragility due to the conditions causing further bone density loss. This can happen to anorexic and bulimic sufferers of all ages.

Older people should aim to consume a varied diet, consisting of enough calories for maintaining a healthy weight. 

4) Limit your consumption of alcohol.
We’d recommend that you drink no more than a maximum of 2 units of alcohol per day. Any more than this has been demonstrated to increase the risk of bone fracture. Alcohol abuse has detrimental effects on bone health and increases a person’s risk of developing osteoporosis.

5) Stop smoking and definitely don’t start!
Smoking is a known risk factor for osteoporosis as it increases bone mass loss. In fact, smoking doubles the risk of hip fracture.

Generally, being healthy is the key to avoiding fragility and in particular preventing osteoporosis as we age. Having an annual health medical can highlight any areas of concern. They can monitor the progression of any pre-existing health issues, as well as detect arising conditions in the early stages. You can book your annual medical online

In addition to making healthy lifestyle choices, it is also important to book a doctor’s appointment should you notice any changes to your health. The sooner a health concern is addressed, the easier it is to treat. You can book a GP appointment online.

 

 

Covid-19 Statement: Easing of restrictions in England

24.02.2022 Category: Clinic News Author: Dr Richard Dawood

At Whitby & Co. and the Fleet Street Clinic, we strongly believe in our duty to protect our colleagues and patients alike, independently of Government regulations. We have stayed open since the start of the pandemic, delivering key health services for our patients, face-to-face and without interruption, but with no compromise on safety. 

Despite the recent changes to isolation legislation and access to testing, you can rely on the fact that we plan to keep regularly testing all our staff for the foreseeable future – using highly sensitive rt-PCR tests in our own onsite lab. The benefits of rt-PCR testing means the infection is detected much earlier, rather than at peak infection which is when lateral flow tests only turn positive. We will advise our employees to continue to isolate in the event of a positive test: we prefer to pay our staff to stay at home, rather than risk spreading  Covid-19 among colleagues or to our patients.

Whilst we absolutely recognise that the Omicron variant is less severe than previous dominant strains of SARS-CoV-2, we are not willing to compromise the health and wellbeing of our employees or patients when the severity is so unpredictable person to person. For peace of mind and to protect those most vulnerable, we will continue to wear face masks and prevent infectious individuals from entering our premises.

Our internal strategy appears thus far to be successful: although a number of us have inevitably had Covid-19 over the course of the pandemic, there have certainly been no outbreaks among staff from workplace transmission. 

Beyond this, you can rely on the fact that all our staff are fully vaccinated, and indeed (like all health workers) were prioritised for vaccination from the earliest opportunity.

Whatever your reason for coming to see us at 29 Fleet Street – whether for an eye examination, a GP appointment, travel vaccines, or to use any of our other services, you can be confident that we have all been vaccinated and have had a recent negative coronavirus test. And this extends to if any of us come and see you at your home, office or place of work, you can be completely assured that we have used all our resources to protect you, your family and your colleagues.

How To Set Up Your Workstation At Home

17.02.2022 Category: Osteopathy Author: Andrew Doody

In theory, a hybrid working week is the best of both worlds for both the employee and the employer. It combines the best of pre-Covid collaborative office-based working with the flexibility of working from home. Allowing employees to be fully engaged with the company and their colleagues all whilst offering the opportunity for solo focus that comes with home working. It is thought that many companies will permanently adopt a ‘hybrid’ way of working.

With this being a long term model of working, many people have realised that their makeshift home office will not suffice without causing havoc on their bodies. Making sure that the physical and ergonomic set up of your home office is correct is imperative for avoiding any musculoskeletal problems. 

A bad home office setup has the potential to cause you repetitive strain injury, lower back pain, increase your risk of carpal tunnel syndrome and could even be the cause of your headaches and migraines. It is worth taking the time to understand what a good home office set up is and work out the best way to adapt your setup to make a healthier home working space for you to work from.

Back to basics:

We always start at the basics. Even though they may seem obvious, time and time again it has been proven never to assume the basics are widely known. So, let’s go over them briefly:

  • Choose the right chair: You should invest in a chair that offers adequate support. Try and get a chair that is fully adjustable – meaning you can alter the height, back position, and tilt to best suit you. This will be much more comfortable and will support your body when you’re sat for long periods of time.
  • Support your back: You should adjust your chair so that your lower back is supported, this will reduce strain on your back. Your knees should be slightly lower than your hips. 
  • Arm position: Your elbows should be positioned by the side of your body so your arm forms a right-angled L-shape at the elbow joint. 
  • Screen level: Your screen should be directly in front of you with your monitor placed at about an arms length away, with the top of the screen roughly at eye level. You may need a screen monitor to achieve this. 
  • Keyboard and mouse position: Your keyboard should be placed in front of you with a 4-6 inch gap at the front of the desk to rest your wrists. You might consider a wrist rest. You should aim to position your mouse as close to you as possible. A mouse mat with a wrist pad can help. 

Now for some suggestions a little more out the box:

L-shaped desks

It’s important to be fully facing whatever you’re doing. Trying to work while twisted, even a little, is going to cause problems. This often happens when someone needs to type at a screen, but also use a book, write, or use two monitors. A great solution is to set up your desk in an L shape (two desks perpendicular works). This allows you to swivel your chair to face whatever you’re doing at that moment. 

Supplementary monitors

Plain monitors are cheaper than you’d think. Instead of hunching over a laptop, or piling books up to put a screen on, think about investing in an extra monitor, maybe with a bigger screen and a stand. If you need documents open, think about a second monitor, it will cut down on mouse usage of having to keep swapping between windows. It can also be used vertically to get whole pages on which means less scrolling. Equally, extra keyboards and mice are really quite cheap and ergonomically so much better. Lots of different mice for arm/shoulder complaints are available. You can have a full setup in place and simply plug in your laptop when you arrive.

Foot stools

If your desk isn’t height adjustable, chances are your chair is adjusted to match the desk, not you. This is ok, as long as your feet are still flat on the ground with knees at about 90 degrees. If not, you may find a footrest makes a great difference, taking pressure off the back of the thighs and preventing over extension of the lower back. If you’re too tall, leg extensions for the desk are a simple remedy.

If you’re looking at buying a new desk. I recommend adjustable ones. Costco stocks an electric one for under £200. This can allow you to spend part of the day working, standing.

Aesthetics

Creating an environment that is visually pleasing will do wonders for your mental wellbeing. This is equally as important as physical setup and will improve mood, lower levels of tension, and increase productivity. Try to utilise lots of natural light if you can. Position your desk where it feels airy and open. Choose light colours to surround your workspace. Add a couple of green leafy plants. Whatever little changes that make you feel happy!

Movement 

Try to incorporate regular movement to your working day. If you can, get up every hour for 30 seconds and have a quick stretch. When working statically for long periods of time, the muscles fatigue. 

This may all seem like a lot to consider for a workstation but these are simple changes that can easily be implemented. Optimising your work space can make a huge difference in both your comfort and productivity. 

If you are experiencing any musculoskeletal problems, book an appointment online with our osteopath, Andrew Doody. 

Or for more information on osteopathy, see here

BCG & SCID screening:
What you need to know

07.02.2022 Category: General Health Author: Anna Chapman & Lucy Mildren

In September 2021, Public Health England released new rules surrounding the timing of BCG vaccination, increasing the minimum age of vaccination to 28 days. This has been implemented in line with a pilot disease screening programme that tests eligible newborns for Severe Combined Immunodeficiency (SCID), the outcome of which becomes available by the time the baby is 6 weeks old. It is important that we wait for the result of this test before giving the BCG vaccine.

What is SCID screening?
All newborn babies in the UK are currently offered blood spot screening (heel prick test) that looks for 9 rare diseases, including sickle cell and cystic fibrosis. The NHS is considering introducing an additional test for Severe Immunodeficiency (SCID), a name given to a group of rare, inherited disorders that cause major abnormalities in the immune system. Affected infants have an increased risk of life-threatening infections and will normally become severely unwell in the first few months of life. Without treatment they will rarely live past their first birthday. About 14 babies a year are born in England with SCID.

The evaluation of this testing, which began on 6th September 2021, is taking place in 6 areas across England and will cover around 60% of new born babies. It is running alongside the existing blood spot screening and the intention is to roll it out nationally once the 2 year evaluation has been made. 

Why does this affect the BCG vaccination?
Bacillus Calmette-Guérin (BCG) is a live attenuated vaccine that can cause problems if given to an immunocompromised person. Treatment for SCID is more complicated if the child has received the BCG vaccine, so it is important that if your child has been tested. We wait for a negative result before vaccinating. 

What we need from you:
If your child was included in the SCID programme, you will need to provide a letter that confirms the negative result of screening.

If your child was born outside of the programme areas and therefore, not included in the SCID programme, we will need to see a letter confirming this. 

In either case, please bring the letter with you to your appointment, as well as your child’s vaccination book.

Nb. If your child was born before 1st September 2021, before the programme was introduced, no letter will be needed. 

 

For more information on:

BCG vaccination

Other Childhood Vaccinations

Travelling for Chinese New Year?

01.02.2022 Category: Travel Health Author: Anna Chapman

Chinese New Year is a festival celebrated annually by Chinese communities across the world to bring good luck and prosperity into the New Year. Every year corresponds with one of the 12 animals in the Chinese Zodiac, with 2022 being the Year of the Tiger. Celebrations for Chinese New Year kick off on the 1st Feb, continuing until the 15th February where the festivities culminate with the Chinese Lantern Festival. Every year, thousands of people travel to China to enjoy the celebrations. So, if you are one of those people who are planning to travel to China to join in with the festivities, please ensure you follow these tips to stay healthy whilst abroad.

Firstly, you may want to check the entry requirements for China in terms of required covid-19 testing. Recently the Chinese Embassy in the UK announced a temporary suspension of entry into China by non-Chinese nationals in the UK holding Chinese visas or residence permits valid at the time of the announcement. If you are unaffected by these restrictions and still travelling to China you can view what covid-19 testing entry rules are currently in place here: GOV.UK WEBSITE. You can find more information on our rt-PCR Testing service here and our Lateral Flow Testing here.

Covid aside, check your vaccination history. All travellers need to ensure they are up-to-date with their childhood vaccines, most importantly, Hepatitis A, Measles, Mumps and Rubella (MMR), and Diphtheria, Tetanus and Polio (DTP).
More information on our wellness vaccinations can be found here.

It is worth noting that it is still influenza season in the northern hemisphere and transmission can occur well into spring. Those travellers who haven’t received their annual flu vaccination to protect them against the most common strains for 2021-22, should ensure they receive it before travelling to China. You can still book your annual flu vaccine, here.

Travellers who are planning extended stays, and more remote and rural travel may also wish to consider vaccinations against Typhoid, Rabies and Hepatitis B.
More information on our travel vaccinations can be found here.

Those who are heading further south to rural areas where the weather is warmer may wish to consider vaccination against Japanese Encephalitis (JE),  which is spread via the culex mosquito. You can also purchase our ‘Ultimate Bug Kit’ which will help protect you from mosquito bites.

There have been recent cases of Avian Influenza (bird flu) in both the UK and China. Bird flu is a very unpleasant illness which can cause people to fall quite unwell. It is passed on via contact with infected birds. Travellers can minimise risk by avoiding contact with any birds (dead or alive): avoid touching dead or dying birds, and steer well clear of  ‘wet markets’ (marketplaces that sell meat, fish, and often live animals including birds).

Chinese New Year is heavily focused on food, with items such as fish, fruit and dumplings symbolising luck, wealth and prosperity. Travellers should ensure that they maintain good food and water practises to avoid tummy trouble whilst away. You should avoid tap water and ice made from tap water, instead stick to bottled water. Ensure you wash your hands thoroughly before eating and after using the toilet. Ensure all food that you eat is cooked thoroughly and served straight to you.  And lastly, consider taking medicines for self-treatments with you, such as antibiotics – take our Online Travellers’ Diarrhoea Consultation to see if it is suitable for us to prescribe you standby Travellers’ Diarrhoea treatment.

By following these guidelines and ensuring you are generally sensible and hygienic, you will be able to relax and enjoy the sheer joys of travel and seeing the world.  

Happy Chinese New Year! 

 

You can book online for a travel consultation appointment here.
Or for more information on all of our travel vaccinations, wellness vaccinations or travellers’ diarrhoea.

Winter Health Check

22.01.2022 Category: General Health Author: Dr Belinda Griffiths

With every change of season comes a host of different medical issues, and winter can be one of the worst. With colder temperatures, shorter days, and seasonal illnesses circulating, it is one of the harder seasons to keep fit and healthy. There are certain conditions which are known to worsen in the colder months and so it is important to be aware of them and how you can best prepare yourself to keep healthy throughout winter. 

These conditions include:

  • Asthma
  • COPD
  • Circulatory disorders, such as claudication, Raynaud’s disease, and chilblains
  • Ischaemic heart disease
  • Hypothyroidism (if untreated)
  • Osteoarthritis and any joint disorder to include rheumatoid arthritis
  • Seasonal Affective disorder
  • Allergic rhinitis

To reduce the increased risk associated with the above conditions, it is important to have a check up with your GP, ideally in the early Autumn before the Winter months. This will give you the best chance of getting ahead and allowing you to prepare for the coming season. But, if for whatever reason, you were unable to have a check up in Autumn, it is still beneficial to have a check up during the Winter months.

During a check up for asthma and COPD it’s advised to have a peak flow and lung function check. Asthma and COPD are worse in the dry, cold weather, so it is important to make sure you have plenty of your prescribed inhalers. It is best to be prepared rather than be taken unawares by an attack of wheezing. It is extremely important to see a doctor if you develop winter wheezing and are short of breath, especially during the night as this is when asthma and COPD attacks are most dangerous.

Circulatory disorders are worse in the cold weather as lower temperatures constrict blood vessels, increasing the likelihood of pain due to claudication (pain in the calves after walking a certain distance), Reynaud’s (discolouration of the fingertips due to constriction of the blood vessels) and chilblains (small, itchy, red patches on the skin). You can prepare for all of these conditions by obtaining prescriptions for treatment but most importantly, by keeping  warm and preparing for the cold.

Ischaemic heart disease is also worse in the cold weather due to the effect of constricting blood vessels. It is important to have a cardiac check to include blood pressure, and if you suffer from angina, to ensure you have the medication to treat this painful condition which is likely to be much worse in the cold weather. Avoiding the extreme cold and wearing thermal clothing may also mitigate against the likelihood of a heart attack or myocardial infarction if you do suffer from Ischaemic heart disease. 

If you suffer from Hypothyroidism, it is a good idea to have an annual blood test. Left untreated, hypothyroidism can cause increased sensitivity to cold, which can be particularly unpleasant in winter.

For those with arthritis of any kind, the best way to avoid pain and stiffness in the joints is to keep warm and keep the joints moving. Find more information on Arthritis in Winter here.

If your mood tends to be lower in the winter months, each year, you should have a check up with your GP to discuss Seasonal Affective Disorder (SAD). If you are diagnosed with SAD, consider CBT (Cognitive Behavioural Therapy) rather than medication if you can, and invest in a daylight lamp as these do help.

Allergic rhinitis is another ailment that tends to crop up a lot around winter time. This is diagnosed when you have a persistent nasal discharge. This can occur either as a result of pine or autumnal tree leaf mould, or due to house dust or mould which is often exacerbated by central heating. In this instance, nasal sprays and antihistamines are often required.

Finally, the Norovirus peaks in November until April. This is a really unpleasant vomiting virus which is picked up from contaminated surfaces or foods. To help avoid this nasty bug, always wash hands when handling food and make sure food is washed thoroughly before cooking or eating raw.

If you know or suspect that you might suffer from any of these conditions, please do visit your GP to help you keep prepared. Similarly, if anything new arises you should see your GP as soon as you can; the earlier a health condition is addressed, the easier it is to treat. 

In general, an annual medical is a good way to give you a full-body overview of your health, as well as monitor the progression of any existing health conditions. A varied, balanced diet and regular exercise will also be crucial in keeping you generally fit and healthy throughout winter.

 

For more information on our GP Services

Book a GP Appointment or an Annual Medical.

Case Study:
Covid-19 Crisis Management - Kenny Wax Productions

17.01.2022 Category: Case Study Author: Dr Richard Dawood

Throughout the pandemic we have supported many industries trying to navigate business-as-usual alongside managing the potential risk of coronavirus in the workplace.

Identifying covid-positive individuals as well as outbreaks is essential, but it is also important not to underestimate the peace of mind testing brings to employees who may be anxious about catching covid-19 in the work environment, especially those who have been in close contact with someone at work who has subsequently tested positive.

The creative arts industry has been particularly impacted by closures, and given  the close-contact nature of the theatre and performing arts sector, outbreaks do occur. The speed at which those infected can be identified can make all the difference between a show going ahead or being cancelled.

We have supported Kenny Wax Productions for the last 2 years with crisis management and routine testing using our ultra-rapid covid-19 rt-PCR testing service.

Here’s how we supported the production of MAGIC GOES WRONG during their Christmas crisis:

At 15:18 on New Year’s Day (a Saturday), we received a text to say that the entire cast of MAGIC GOES WRONG was heading straight to Fleet Street, following a positive result from one of their actresses. The only way the evening performance could go ahead was to determine whether covid-19 had spread throughout their cast, or not.

We understood the urgency of this situation and quickly and calmly took samples from a cast of 21 against the clock. We ran them through our lab at the same time, which can be quite a challenge. Since we knew that there would not be enough time to re-run samples, this needed to be done with special care. For us to be able to give Kenny the “thumbs up” to go ahead with the evening show, it was imperative we got things right the first time.

One of the best things about our NeuMoDx lab equipment is that we can load each sample as soon as it is taken, rather than waiting for the complete batch. We started running samples immediately, the last of them had finished running by 18:10, when we were able to assure Kenny that it was safe for the cast to go on with the show.

We were able to go from initial text enquiry to sample-taking and final, confirmed results for the entire cast in just over 3 hours.

Kenny Wax, the Producer of MAGIC GOES WRONG explains:

“Our West End hit MAGIC GOES WRONG had managed to avoid shutdown. However, an actress who had been feeling a little unwell leading up to New Year and continuously tested negative on lateral flows, finally came through with a positive test on Saturday morning 31st December. Hearing this news, the rest of the cast became very anxious about continuing performances until they were confident that covid had not spread throughout the company.

As Producer of the show, I was made aware of this information at 1.45pm. There was due to be a matinee at 2.30pm and an evening show at 7:30pm. We had no other option than to cancel the matinee but in an attempt to save the evening performance (a Saturday Night), at very short notice we attempted to get the whole company of 21 people PCR tested in the afternoon. To achieve almost the impossible everyone set off for the Fleet Street Clinic and by 6.10pm, we received the good news that the rest of the company had tested negative on the PCR and we were able to continue with the evening performance and the following two
shows on the Sunday. This not only saved us another financial blow due to cancellations at the box office, but we were able to provide entertainment to 1,500 customers across those three performances.

Dr Dawood’s staff at the Fleet Street Clinic are always polite, friendly and efficient. They fully understood the nuances of working with a West End theatre production company on a very tight deadline. I am very grateful for their continuing support and cannot recommend them highly enough.”

For more information on our corporate coronavirus testing services and other covid-19 support services.

Choosing the Right Corporate Healthcare Programme

Read more

What is "Blue Monday"?

17.01.2022 Category: General Health Author: Dr Will Cave

Blue Monday happens every year on the third Monday of January. It is supposedly the most depressing day of the entire year, based on a crude calculation of bad weather, long nights, back to work dread and post-Christmas debt.  

It does sound very plausible but Blue Monday is in fact, a myth! 

The phrase “Blue Monday” was coined by Sky Travel in 2005 as a way to sell holidays in January. They highlighted all the seasonal negatives to reinforce the benefits of booking a holiday – a clever marketing trick. 

But can we really pinpoint the most depressing day of the year?

There is no actual scientific studies that have ever backed up any claims about Blue Monday being true or that there could even be a “most depressing day of the year”. This does make sense because this would be different for each and every one of us based on personal circumstances and the variables are extensive.

Perhaps then instead of selecting just one day of the year to highlight depression, we should be thinking about mental health, specifically poor mental health, everyday.

Depression is more than simply feeling unhappy or fed up for a few days. It can be long lasting and the symptoms range from mild to severe. Once accessed by a doctor, they will conclude the severity of your depression.

A simplified description follows: Mild depression will have some impact on your daily life, moderate depression has a significant impact on your life and severe depression makes it almost impossible to get through daily life.

Sometimes there’s a trigger for depression. Life-changing events, such as bereavement, losing your job or giving birth, can bring it on. Other times, it can be linked with family history, people with family members who have depression are more likely to experience it themselves. But you can also become depressed for no obvious reason. It is quite complex and each person is unique.

There are many symptoms of depression and the combination is unpredictable. They can be categorised at physiological, physical and social symptoms.

Some examples of psychological symptoms of depression include:

  • continuous low mood or sadness
  • feeling hopeless and helpless
  • having low self-esteem
  • feeling tearful
  • feeling irritable and intolerant of others
  • having no motivation or interest in things
  • finding it difficult to make decisions
  • not getting any enjoyment out of life
  • feeling anxious or worried
  • having suicidal thoughts or thoughts of harming yourself

Some examples of physical symptoms of depression include:

  • moving or speaking slower than usual
  • changes in appetite or weight (usually decreased, but sometimes increased)
  • constipation
  • unexplained aches and pains
  • lack of energy
  • low sex drive
  • changes to your menstrual cycle
  • disturbed sleep – for example, finding it difficult to fall asleep at night or waking up very early in the morning

Some examples of social symptoms of depression include:

  • avoiding contact with friends and taking part in fewer social activities
  • neglecting your hobbies and interests
  • having difficulties in your home, work or family life

The most common symptoms of depression tend to be a low mood, feelings of hopelessness, low self-esteem, lack of energy, problems with sleep and a loss of interest in things you used to enjoy but it can be any number of symptoms listed above. 

It’s important to seek help from a GP if you think you may be depressed. The sooner you see a doctor, the sooner you can be on the way to recovery. 

For more information on GP services at Fleet Street Clinic, click here.

How To Lose Weight Safely And Successfully

14.01.2022 Category: Dietitian Author: Dr Belinda Griffiths and Ruth Kander

Weight loss has become a thriving industry and we’re bombarded constantly with unhealthy FAD diets, weight loss programmes, influencers selling teas and pills all promising to help us lose weight. Many of these are promoting quick fixes which are not advised by doctors or dieticians. It can be really hard to know what information to trust. To help navigate the sea of information (and misinformation!) surrounding weight loss, we have asked one of our GPs, Dr Belinda Griffiths, and our dietitian, Ruth Kander, their advice on how to lose weight safely and successfully. 

Firstly, it is important to note that weight loss should be consistent and gradual as it can be dangerous to lose too much weight too quickly. Dr Griffiths suggests that “a safe weight loss is 1-2 lbs or 0.5-1kg per week… Greater weight loss than this per week can lead to malnutrition, exhaustion, increased risk of gout and gallstones.” There is also an increased risk of developing an unhealthy relationship with food which, in extreme circumstances, could lead to eating disorders. 

Ruth added, “Losing weight gradually and at a healthy rate is key.” Remember, it’s all about consistency! Perseverance will amount to healthy lifestyle changes which will allow you to achieve your weight loss goal. 

Don’t underestimate diet

Both Dr Griffiths and Ruth agree that diet is the most important factor when it comes to weight loss. As Ruth explains; “having a healthy balanced diet that is lower in calories than our body uses is a good way to start the weight loss journey. If we don’t reduce calorie intake, one won’t lose weight:.”  – this is known as being in a calorie deficit. The amount of calories that will result in weight loss will vary from person to person and depend on the amount of exercise the individual does. In order to lose weight, you will need to burn more calories than are consumed and therefore restricting your calorie intake is the simplest way of losing weight. 

Foods to focus on

Ruth recommends that “people should focus on a variety of foods when trying to lose weight”. While Dr Griffiths suggests, “focusing on a range of lean proteins (including meat and fish), vegetables, high fibre foods (such as quinoa, bran flakes etc) and fruit in moderation”. Vegetarians can substitute in lentils, nuts, beans and tofu instead of meat and fish. In general, high calorie foods such as fried food, cakes, biscuits, chocolate and sugary drinks should be avoided. 

Let’s get physical!

Although weight loss is still achievable without much exercise, incorporating exercise into your lifestyle will not only aid weight loss, but will generally improve your overall health. Any exercise is better than none whether it be tennis, swimming, or even walking, “whatever you are capable of, just do it!” is Dr Griffiths advice. Ideally, a combination of exercise is best for weight loss – this includes cardio / fat burning and resistance or weight training. Get those steps in! An easy way to incorporate more exercise into your daily routine is by aiming to walk at least 10,000 steps per day. This easy change can make a big difference and remember, as Dr Griffiths says “the more exercise you do, the greater calories are burned” – it’s as simple as that!

Don’t forget about NEAT movements! 

NEAT (or Non-exercise activity thermogenesis) movement refers to the physical movement we do day-to-day that isn’t necessarily planned exercise and “encompasses the energy that we expend by simply living”.This includes the calories we burn breathing, eating, sleeping etc. Dr Griffiths suggests that “you can increase NEAT movement easily in your everyday life by making simple changes such as taking the stairs rather than the lift, by standing rather than sitting, by walking instead of taking the train/ bus/ tube or even by carrying bags rather than having items delivered”. It all adds up! These simple swaps will increase the number of calories you burn and help facilitate weight loss. 

What to do when you plateau

The first stint of weight loss can make it seem a little too easy as you tend to lose weight more easily in the beginning, but a common issue lots of people face is when weight loss reaches a plateau. This is where you stop losing weight to the same extent you were before, or stop losing weight for a period of time. This can feel disheartening and more often than not, people tend to give up at this stage. Dr Griffiths states at this point “it is a case of persevering with calorie restriction and regular exercise and gradually weight loss will resume.” If it doesn’t, Ruth suggests “ looking at what you’re eating to see if anything has slipped”. She states “maybe you’re not taking into consideration extra calories here and there” but they all add up. See if there are any areas of your diet where you could be a little stricter, or consider starting or upping your exercise. 

Sleep and Stress

A good night’s sleep and keeping your stress levels down will be your friend when it comes to weight loss. “In order to lose weight, you need to be in the correct frame of mind and life circumstances” says Ruth. Research has shown that you tend to eat more and make poorer food choices, including seeking comfort food, when you are sleep deprived. This is because not getting enough sleep “disrupts the hormones in your brain (Leptin and Ghrelin) that control appetite” says Dr Griffiths. 

Stress can also play a part in weight loss as Dr Griffiths explains that “stress increases cortisol levels which increases gastric acid output and makes you feel anxious and hungry”. Ruth adds “there is also a theory that being stressed can limit weight loss in terms of hormonal activity in the hypothalamic-pituitary axis which can lead to the release of hormones that can limit weight loss”. Keeping it simple, “to lose weight, good sleep and minimal stress would be ideal”. 

Final thoughts

Trying to lose weight can seem complicated, confusing and difficult, but when you really break it down, the ingredients to losing weight successfully are actually very straightforward. If you stick to these simple rules and you are patient and consistent, the weight will come off and you will achieve your goals. 

If you feel that you are doing everything right and you still aren’t losing weight, or are even putting weight on, there could be something else causing this. You may have an undiagnosed underlying medical condition and we’d advise you to visit your GP to make sure everything is well. 

If you would like any extra support with your weight loss, why not book an appointment with Ruth. Or if you have any concerns over your health, please book an appointment with one of our GPs.

Arthritis in Winter

11.01.2022 Category: General Health Author: Dr Will Cave

Arthritis is a common condition that causes pain and inflammation in joints. It is not a single disease but an informal way of referring to joint pain or joint disease. There are more than 100 types of arthritis and related conditions. There are thought to be 10 million people with some form of arthritis in the UK. It is the most common cause of disability in the UK and can affect people of all ages but it does occur more frequently as people get older.

Common arthritis joint symptoms include swelling, pain, stiffness and decreased range of motion. Symptoms can range dramatically from person to person, with some experiencing mild symptoms with occasional flare ups to those who experience constant debilitating pain everyday. The sad truth is that there is no cure for arthritis, so it is all about pain management and how to best reduce flare ups.

The impact of the weather on the symptoms of arthritis has been debated for many years and people tend to report more arthritis flare-ups in the winter, but the reason why is not specifically known.

Quite often sufferers will state that their symptoms get worse when the weather is damp and cold and some state they are able to tell when the weather is about to change based on their arteritis symptoms worsening.

Even if there is currently nothing to support this scientifically, this doesn’t remove the pain felt by sufferers and so rather than comment on where this is true or not, let’s look at ways to reduce flare ups in winter.

Our top 4 tips:

1. Stay warm
When the temperature drops both inside and outside, dress warmly. Make sure all arthritis prone areas are kept warm.

2. Stay hydrated
Drink plenty of water throughout the day. Even mild dehydration might make you more sensitive to pain.

3. Take warm baths
A warm bath or visiting a heated swimming pool will ease joint pain and comfort you. If you visit a heated swimming pool, gentle exercise will also help your mobility.

4. Stay active
It is now clear that active people experience less joint pain than those who are sedentary. If you are experiencing an arthritic flare then reduce your usual activity (but don’t stop altogether) and use simple anti-inflammatory medication such as ibuprofen if it is safe for you to do so.

 

Enjoy winter while taking the above precautions for Arthritis.
If you are facing extreme discomfort and pain in your joints due to arthritis, book an appointment with a GP to discuss your options.

Beat the January blues

05.01.2022 Category: General Health Author: Dr Will Cave

If you are feeling sad at the start of the year, don’t worry, you are not alone. 

Although it comes around every year, we always seem to be caught off-guard by what has now commonly become known as “The January Blues”.

The January blues is another name for situational depression and is associated with the way we think and feel. Around this time of year, the weather is cold and gloomy, the days are shorter and the nights are longer, plus you may be experiencing post-Christmas exhaustion, debt and perhaps even dread going back to work. 

Symptoms of the January blues are things such as low mood and sadness, lack of motivation, tiredness and low energy. These are all normal feelings, if temporary. 

Most likely, your negative mood will be brought on by the anticlimax of reality after the exciting events of December & the New Year. Ever heard that old phrase, “don’t cry because it has ended, but smile because it happened”? Find comfort in knowing that you are absolutely not alone in feeling blue in January. In fact, many people in the UK feel especially down in January but the good news is that the January Blues are temporary and typically only last a couple of weeks. You don’t need to take any medication as your thoughts and feelings should naturally return to normal.

If it doesn’t and you are experiencing prolonged or worsening thoughts and feelings, you may actually have Seasonal Affective Disorder or SAD, which is different. SAD is clinical depression caused by a person’s biology. It is much longer-lasting, sometimes months on end and likely to occur every year in winter. You should see a doctor to discuss your symptoms as if you have SAD, a range of treatments are available to assist recovery. More information on SAD can be found here.

Remember, please be kind to yourself and know that you’re not alone.

 

For more information on our GP Services.

To book a GP appointment online, click here.

Hypnotherapy Service Update

04.01.2022 Category: Clinic News Author: Sandeep Karavadra

We no longer offer hypnotherapy at Fleet Street Clinic. 

In 2021 we stopped providing hypnotherapy as a service to our patients. We do still offer other supporting services, which may be of interest and suitable for your needs:

If you are unsure, please contact us and we can assist you further.

 

For an overview of all other services available at Fleet Street Clinic, click here.

How Acupuncture can support healthy well-being

Read more

Reasons Weight Gain May Not Be Your Fault

21.12.2021 Category: General Health Author: Dr Belinda Griffiths

Most people experience fluctuations with their weight and it is common to gain weight naturally as we age. For the most part, diet changes, eating more or reducing exercise are the main causes for gaining weight. However, if a person gains weight in a short period of time for no reason, this could be the sign of an undiagnosed, underlying health condition. There are several conditions and circumstances that are known to cause weight gain, some of which can be serious and require medical attention. 

Here are just some medical conditions which can cause sudden weight gain:

Polycystic ovary syndrome (PCOS) 

This is a hormonal condition which affects the way a woman’s ovaries work. A common symptom of PCOS is weight gain, particularly around one’s middle. Weight gain is rarely the sole symptom, it is usually part of multiple symptoms including acne, excessive hair, irregular periods and/ or thinning hair. PCOS makes women less sensitive to insulin or cause insulin-resistance which can lead to weight gain and secondary conditions such as diabetes.

Hypothyroidism

A common cause of unexplained weight gain in men and women comes from having an underactive thyroid. This is because when a thyroid is underactive it doesn’t produce enough thyroid hormones, which in turn affects your metabolism, slowing it down. Hypothyroidism can be diagnosed with a thyroid function test and if diagnosed, it can be easily treated with a replacement hormonal tablets. 

Cushing’s syndrome

This is a rare hormonal disorder which is caused by elevated levels of cortisol in the body. Cortisol is responsible for regulating metabolism and appetite, which means elevated levels can slow down your metabolism as well as increase hunger, both of which can cause weight gain.

Insomnia / chronic lack of sleep

Being sleep deprived can result in making poor food choices, including seeking unhealthy foods and eating more than usual. This is thought to be because a lack of sleep disrupts the hormones in the brain (Leptin and Ghrelin) that are responsible for appetite. 

Medication 

Certain medications affect metabolism which can cause weight gain and weight loss. Medications such as steroid medication can cause weight gain, bloating and swelling due to water retention. 

Lipoedema

This is a problem caused by an issue with the lymphatic system that causes an abnormal build-up of fat in the legs and sometimes the arms. This usually results in the upper body being generally a much smaller size compared to the lower half of the body but typically affects both sides of the body equally. This condition can also be painful and cause tenderness or heaviness in the limbs. Lipoedema mainly affects women and it is rare in men. 

Chronic stress, depression and/ or anxiety

Mental health issues can sometimes cause people to turn to food as a coping mechanism, often triggering compulsive eating behaviours. Additionally, higher cortisol levels are often found in people with depression which is known to increase appetite and the motivation to eat. Antidepressant medication can also increase hunger as they interfere with serotonin levels – a neurotransmitter that regulates appetite. 

Menopause

Women going through the menopause often experience weight gain. Changing hormone levels affect the way the body stores fat and can cause women’s bodies to store, rather than burn, calories. Women also generally need less calories after the menopause, and so, if you do not adjust your calorie intake, you are likely to put on weight. 

PMS

During PMS (premenstrual syndrome), progesterone levels surge and dip which are known to increase appetite (the cause of which are unknown). PMS can also cause weight gain as a result of water retention. 

While many of these causes are rare, they are possible and anyone experiencing unexplained weight gain should visit their GP to rule out anything that may require medical care or treatment. It’s always best to be on the safe side! And if everything is normal, your GP can provide you with tips and advice on how to manage your weight gain. 

 

If you are experiencing unexplained or sudden weight gain, or think you might be displaying symptoms of the conditions mentioned above, please book a GP appointment today.

Fleet Street Clinic receives UKAS ISO15189 Accreditation

13.12.2021 Category: Clinic News Author: Dr Richard Dawood

Fleet Street Clinic receives UKAS ISO 15189 Accreditation for testing of SARS-CoV-2 (COVID-19)

Fleet Street Clinic has confirmed its UKAS ISO 15189 accreditation for the detection of the SARS-CoV-2 virus (COVID-19), granted on 8th December 2021.

UKAS is the National Accreditation Body for the United Kingdom and is appointed by the UK Government to access competence and accredit organisations that provide testing services. It is an internationally recognised accreditation body.

Fleet Street Clinic has been at the forefront of private Covid-19 testing since the start of the pandemic and is one of the very few private healthcare clinics in London who can deliver ultra-rapid testing to private patients and corporations.

Receiving the UKAS ISO 15189 accreditation confirms that Fleet Street Clinic has continuously met the standard of accuracy and safety for private covid-19 testing and offers quality assurance. 

Our full scope of accreditation can be found ​​https://www.ukas.com/wp-content/uploads/schedule_uploads/977296/22197-Medical-Single.pdf

With almost 25 years of diagnostics experience, Fleet Street Clinic can be trusted with confidence to deliver private Covid-19 testing.

 

 

Christmas Opening Times

26.11.2021 Category: Clinic News Author: Sandeep Karavadra

Fleet Street Clinic will be fully closed on 25th December so our hardworking employees can enjoy Christmas day with their families. 

We reopen on 26th December for Covid-19 rt-PCR testing only, with all other services resuming in the New Year, on Tuesday 4th January.


As in previous years, we will be available for urgent medical help throughout the Christmas period. However, please remember we are not an alternative for 999. For life-threatening emergencies, immediately contact 999 for assistance.

To avoid running out of your regularly taken medication and/ or your contact lenses, please submit your requests, outlining your requirements to info@fleetstreetclinic.com as early as possible.

Please submit your requests before:

For repeat prescriptions: 11am, Friday 24th December 2021 (please note we cannot guarantee stock of all medication).

For repeat contact lenses: 5:30pm, Friday 10th December 2021.

For spectacles: 5:30, Friday 3rd December 2021. 

Covid-19 rt-PCR Testing available over Christmas by appointment only

If you need a Covid-19 rt-PCR test over the festive period, we’ve got you covered. 

We’ll even be able to deliver same-day (2-5 hrs) results for those needing rapid turnarounds. 

All Covid-19 rt-PCR tests are to be booked in advance and by appointment-only.

24th December 9 am – 5:30 pm All Services Available
25th December CLOSED
26th December – 3rd January 9 am – 5:00 pm Covid-19 rt-PCR Testing only
4th January Normal Hours Resume All Services Available

Please note, you can pre-book your Covid-19 rt-PCR test for during the Christmas period & for in the New Year online.

Book Now

Merry Christmas and a Happy New Year from all at Fleet Street Clinic.

We look forward to seeing you in the New Year.

Flu protection for expecting mothers

11.10.2021 Category: Flu Jabs Author: Dr Richard Dawood

Some infections can harm your baby if you catch them during pregnancy. Research suggests that the flu, in particular strains such as H1N1 (swine flu), can significantly increase the risk of complications to expecting mothers and their unborn babies.

Vaccinating expecting mothers against flu or before pregnancy can provide the newborn baby with significant ‘passive’ protection – which can last several weeks after birth. This is important because babies cannot be vaccinated themselves until they are 6 months old. So, a mother’s vaccination is strongly advised.

Fleet Street Clinic are urging all the mums-to-be to have the vaccine. The Quadrivalent Flu Jab can be safely given at any point during pregnancy.

Pregnant women are less able to fight off infections and therefore more likely to be seriously ill if they contract the flu virus. Pregnant women are at risk of complications from the flu at any stage of pregnancy. So therefore, it is important for those expecting to get their flu jab as early as possible.

If you are currently planning your pregnancy, it would be sensible to consider getting your flu jab prior to becoming pregnant.

The flu vaccine can safely be given to pregnant women at the same time as the whooping cough vaccine. You can have the whooping cough vaccine from 16 weeks onwards.

The vaccine is inactivated, and cannot cause flu itself.
Having the flu vaccine is the best protection.

Book Online

If you are interested in booking flu vaccinations for your staff, visit flujabs.org for more information and to get a quote.

Preventing cervical cancer

19.07.2021 Category: Cancer Author: Dr Belinda Griffiths

Women between the ages of 25 and 64 are invited for regular cervical screenings where a healthcare professional looks at the health of the cervix to detect any cell changes or abnormalities. However, in recent years the number of women attending their cervical screen has fallen, with women between 25-29 having the lowest attendance rates. This is deeply concerning as over 3000 women are diagnosed with cervical cancer each year and 99.8% of those cases are preventable. Prevention is always easier than curing, and the earlier you are aware of any cell changes, the easier it is to treat.

Why do some women not attend their cervical screenings?

One of our general practitioners, Dr Belinda Griffiths, has found that in her experience women don’t attend their cervical screenings for a number of reasons including: difficulties with taking time off work for a GP appointment, fear of embarrassment, and fear of the process being uncomfortable or painful. 

However, to combat these concerns, the NHS has launched at-home HPV kits. Dr Griffiths explains how they work – “The HPV test is highly sensitive so it separates out those who are HPV-positive and HPV-negative. Those who are HPV-negative will be considered ‘low risk’ for cervical cancer and will be asked to do a future test. Those who are HPV-positive will be deemed ‘high risk’ and be asked to attend for follow-up with a clinician whereby they will conduct a cervical screening to check the health of their cervix and investigate if any abnormal cells are present.”

These new tests are the same process as at-home STI tests whereby a simple swab collects the sample from the vagina. Having the option of this sort of test at home removes the fear some women may have surrounding the slightly more intrusive cervical screen.

What is HPV?

HPV (human papillomavirus) is a common virus passed on via skin-to-skin contact, usually through genital contact. There are many types of HPV, most of which are harmless, don’t usually cause any symptoms and the infection will go away on its own. However, others are deemed ‘high risk’ as they can persist and cause cell changes which can lead to cancer. It is thought that these ‘high risk’ HPV strains are responsible for around 80% of cervical cancer cases, making the detection of HPV all the more important.

How can you prevent HPV?

You can be protected from certain HPV strains through vaccination. There are two HPV vaccines currently available in the UK: Gardasil which protects against 4 strains of HPV used in the NHS and the vaccine used here at the Fleet Street Clinic, Gardasil-9, which protects against 9 of the high-risk HPV strains.

When can you be vaccinated against HPV?

The NHS now routinely offers the Gardasil vaccine to girls and boys around age 12/13, before the age people generally become sexually active. However, the vaccination programme only came into full force in 2019, meaning many people are currently unvaccinated. It should be pointed out that adults can get vaccinated at any age and even if you have already been exposed to HPV, the vaccine can still offer protection against other strains to which you have not yet been exposed. 

It is a particularly good idea for people to get vaccinated before they attend university or before they go travelling on a ‘gap year’, as these are typically times where young people are more sexually active and therefore more likely to be exposed to HPV. 

It is important to note that getting the HPV vaccination most certainly doesn’t mean missing or not participating in HPV tests or cervical screenings. A combination of these preventative measures gives you the highest possible chance of preventing cervical cancer. 

Book your Cervical Screen or HPV vaccine online today.

The health benefits of sleep

19.07.2021 Category: General Health Author: Dr Belinda Griffiths

Sleep is one of our greatest allies when it comes to health and wellbeing. It is associated with a number of health benefits which can have a huge positive impact on our daily lives.

Conversely, a lack of sleep can be detrimental – research has even found that not getting enough sleep can negatively impact some aspects of brain function to a similar degree as alcohol intoxication!

Dr Belinda Griffiths discusses some of the mental and physical health benefits of getting a good night’s sleep. 

Immune System

During sleep, your body releases cytokines, which are essential for the regulation of the immune system. Cytokines are required in increased amounts when you are attacked by a pathogen (when you’re ill) or under stress. The level of cytokines increases during sleep, and therefore lack of sleep hinders the body’s ability to fight infections. This is also the reason why the body tends to sleep more while suffering from an infection. 

Weight Control

When you’re well-rested, you’re less hungry. Being sleep deprived disrupts the hormones in your brain (Leptin and Ghrelin) that control appetite.

With those out of balance, your resistance to the temptation of unhealthy foods goes way down. And when you’re tired, you’re less likely to want to get up and move your body. Together, it’s a recipe for putting on the pounds!

Athletic Achievement

If your sport requires quick bursts of energy, like wrestling or weightlifting, sleep loss may not affect you as much as endurance sports like running, swimming, and biking. But you’re not doing yourself any favours. Besides robbing you of your energy and time for muscle repair, lack of sleep saps your motivation, which is what gets you across the finish line. You’ll face a harder mental and physical challenge – and see slower reaction times. Proper rest sets you up for your best performance. 

Memory

When you’re tired, you can have difficulty recalling information. That’s because sleep plays a big part in both learning and memory. Without sufficient sleep, the brain finds it difficult to focus and take in new information in the first place and then doesn’t have enough time to properly store information as short-term memories. Sleep helps enable you to retain memories and store information.

Sleep also allows for your mind to rest, repair and rebuild, the same way it does for your body. As you sleep, your brain begins to organise and process all the information you’ve taken in during the day. It converts these short-term memories into long-term memories – this helps you to learn.

Concentration 

Not sleeping properly can mean that both your body and brain don’t function properly the next day. It can impair your attention span, concentration, strategic thinking, risk assessment, reaction times and problem-solving skills. This is particularly important if you have a big decision to make, are driving, or are operating heavy machinery. So, getting plenty of sleep can help you stay sharp and focused all day long. 

Mood 

Another thing your brain does while you sleep is process your emotions. Your mind needs this time in order to recognise and react in the right way. When you cut that short, you tend to have more negative emotional reactions and fewer positive ones. Lack of sleep can cause bad temper and anxiety, so the better you sleep, the better your ability to stay calm, controlled and reasonable. 

Chronic lack of sleep can also raise your chance of having a mood disorder. One large study found that people with insomnia were five times more likely to develop depression, and the odds of having anxiety or panic disorders are even greater.

A refreshing slumber helps you hit the reset button on a bad day, improve your outlook on life, and be better prepared to meet the challenges of the next day.

Heart Health 

While you sleep, your blood pressure goes down giving your heart and blood vessels a bit of a rest. The less sleep you get, the longer your blood pressure stays up during a 24-hour cycle. High blood pressure can lead to heart disease and strokes. Therefore, it is important to keep your blood pressure down. 

Pain Threshold

Poor sleep and pain mutually reinforce each other. Sleep deprivation increases pain sensitivity and reduces pain tolerance. Therefore, something will feel more painful when you’re tired. 

It is clear that sleep is an essential part of helping us stay physically and mentally healthy. What better excuse to have a few extra hours of sleep a day! 

If have any concerns about your health, book a GP appointment today.

Is Your Sleep Position Impacting Your Sleep Quality?

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The best positions for cycling

03.07.2021 Category: Osteopathy Author: Andrew Doody

SUMMER CYCLING

Summer and Tour de France is upon us! Why not use the opportunity to dust off your bike and think about turning that commute into an opportunity to get fitter or shed a few pounds?

Cycling – a low impact sport

Compared to many sports, cycling is one with a relatively low injury rate. Crashes and collisions apart, cycling is impact free – good for your joints and muscles. In addition, if you select the correct gear to match the terrain, it means that you can avoid overloading your muscles and joints, keeping the cranks spinning rather than pushing a big gear.
Also important is that because your feet are fixed in place, spinning the cranks requires very little coordination, which also reduces the risk of injury due to poor technique, which is very common while running. Still, despite all these advantages, cyclists can, and regularly do, suffer overuse injuries.

Fix a good riding position:

One of the main issues is the set up of the bike itself. Here are a few pointers as to how to best achieve a good riding position:

SADDLE HEIGHT

This should be positioned so that when the pedal is at the bottom of the stroke and the ball of your foot is on the pedal, your knee should have a slight bend in it. If you want to get technical, saddle to pedal distance should be 109% of your inside leg measurement. Hips shouldn’t move sideways during crank rotation and you shouldn’t have to stretch at the bottom of the pedal stroke. Don’t be put off by feeling you have to come off the saddle to touch the floor.

SADDLE ANGLE

This should be in a horizontal position, parallel with the floor when viewed side on (but sometimes a very slight downwards tilt can be helpful for those who experience a lot of pressure in the perineum area. However, don’t do this just because it feels more comfortable, as this can cause lessen support and affect riding position).

POSITION OF THE SADDLE

With the pedals adjusted so that they are at the three o’clock and nine o’clock positions, a vertical line dropped from the kneecap of the forward knee should pass through the axle of the pedal.

HANDLEBAR POSITION

This is where opinion varies a little. Racers want the handlebars low to lower wind resistance, climbers want the handlebars low so they don’t feel too high when the bike’s angled up. The rest of us want them higher than this. A good rule of thumb is that you don’t want to be leaning on the handlebars too much, only holding them. If it feels like your upper bodyweight is being supported by the handlebars, try them up a little. Not all bikes are adjustable enough at the front but a stem raise is a cheap efficient way of remedying this. A bit more height in traffic is safer anyway.
And if you haven’t bought your bike yet, put a bit of research into what frame/wheel size you need before you do.
Cycling is a great way to get fit and works well with core stability, however, if any injuries do niggle don’t push through and do get them checked out!

Osteopath at Fleet Street Clinic

Andrew Doody is an osteopath at Fleet Street Clinic and is fully registered with the General Osteopathic Council (GOSC).
Book an appointment with him if you have any musculoskeletal injuries by calling on 0207 353 5678 , email info@fleetstreetclinic.com or book an appointment online.

Managing The Transition Back From Furlough

09.06.2021 Category: Occupational Health Author: Querida Hume-Wright

With over 9 million employees put on the furlough scheme at the peak of the pandemic, and many still on the scheme 12 months later, it’s no wonder that there’s an increase in anxiety about returning back to the workplace. 

With some employees seeming less than enthusiastic about returning to the workplace, it may be concerning for an employer about how they address this anxiety and what to do if faced with this situation. 

From the many Occupational Health consultations we’ve had this past year, we’ve learnt first-hand and also through our clients about the transition back into the workplace for both employees and employers. We’ve been able to get a good picture of the main issues people have been facing and what the underlying cause for the anxiety can be. 

As with any anxiety, the cause can be a singular concern or a combination of concerns and when investigating further, each person should be treated as an individual to fully understand their concerns.

A discussion with an empathetic leader is a great place to start. Sometimes, however, a review by an independent occupational health clinician from a SEQOHS-accredited clinic, like Fleet Street Clinic, is required to work out if the employee is fit to continue working, if any adaptations for working are suggested and some circumstances, what medical help is required. 

Here are some of the main concerns and issues that have come up time and time again from both employee and employer and how these can be mitigated:

Lack of confidence:

Many furloughed returnees may come back wondering if they can still do their job as well as before, which can manifest into a lack of confidence. With not being at work for a long period of time, certain skill sets may have started to feel ‘rusty’. Worries and concerns about returning to full-time hours from the get go, and having to perform at the same level they were at before they went on furlough are just some examples.

What can help with this?
Early engagement between the employer and the returning employee is important to discuss any specific anxieties and to work out a ‘return plan’ which can really make a difference. ACAS advises employers to think about those returning from furlough as if they have been on maternity or long term sick leave. Using similar ‘check ins’ (as you would for maternity/ sick leave) prior to their return to work allows for real-time conversations to cover the practicalities, potentially a staggered return to build up confidence, as well as an opportunity to discuss any anxieties and concerns. 

Concerns over workplace safety: 

Two of the most common themes found in consultations with Fleet Street’s Occupational Health Department were employees worried about safety, and whether going back into the office ‘would be the same’. 

What can help with this?
To help reduce such anxiety, employers have been encouraged to share with those returning their ‘Covid compliant workplace risk assessments’. HSE made these mandatory last year, although officially they do not have to publish their results internally unless there are over 50 employees. Sharing such information on an individual basis would allow the furloughed employee to see what changes and controls have been put in place, giving them reassurance and peace of mind. It also demonstrates to them that the employer is prioritising their health and safety.
Employers should also consider setting up a ‘virtual tour’ of the amended workplace, to enable those returning to see and understand what their new workplace will look like.  Changes such as one-way pathways around the building, socially distanced workstations, extra cleaning of communal areas and bathrooms are just some of the more visual changes. Employers should also take the time to discuss changes in policies such as obligatory wearing of masks, flexible office/home working (if feasible) and other benefits that may have been introduced. Logistical concerns about childcare is one of the major blockers for those returning, and this is another example of how the employer can have open discussion with the returnee to formulate a reasonable solution, preferably weeks ahead of the return to work date. 

Concerns over leaving the home: 

Returning employees may have concerns about leaving the home and what impact this may have on their health. Other factors employers had to think about were those who were shielding (classified as extremely vulnerable by the Government) and for those living in a household with someone shielding. 

What can help with this?
To mitigate this, employers may have chosen to use Occupational Health to contact the employees returning to identify any risk factors or health concerns. Although any medical information would be classified as strictly confidential, the employee and Occupational Health professional discuss the outcome of the assessment which is then simply fed back to HR as ‘fit to return into the office workplace with no adjustments, or with adjustments (then outlined). In the rare circumstance of an employee being assessed as not fit to return to work, a management referral would be indicated. Fleet Street Occupational Health did this for various businesses, and found that many of the employees contacted were appreciative of having been asked about their health in relation to Covid. In a small number of cases, simple and feasible adjustments were recommended – mostly around avoiding a busy commute (flexible working hours were recommended in this instance). Employers fed back confirming the transition for those returning were certainly smoothened by this process. 

Mental Health:

Mental health may have been affected for all employees for many different reasons, these include bereavement, stress from being at home with home schooling, fear of uncertainty etc. It is important that employers recognise this decline in mental health and look to support their employers.

What can help with this?
Employers should consider making sure that all employees are aware of what counselling services are available, or to train up ‘mental health first aiders’ to carry out weekly group check ins or a ‘return to work’ support group. If the employer would like independent advice from an Occupational Health clinician about where the employee is fit to work, then you may want to consider a management referral. They are primarily designed to support the referring manager in their decision making when dealing with an employee’s health-related issue and to determine the employee’s ongoing fitness to work, this includes mental health concerns.

How can the employer support the return back to the office in general?

Employers might consider a ‘phased return to work’ plan, to allow the furloughed employee to steadily get back into work. Both the employer and the employee want the same thing – to be at their best at work, and so allowing a gradual step up in days and hours (again as if returning from long term sick leave as an example) would be one way of enabling this.
Another thing that might help smoothen the transition back for those returning is a ‘buddy’ system. This is where a returnee is matched up with an employee who has not been on furlough to have them work together for the first few weeks. Not only would this help the returnee to navigate any new changes in the workplace, but it can enable collaborative working and remove the ‘grass is greener’ syndrome from both sides. Some examples of known sentiments include furloughed employees wondering if they’ll have a job to go back to, what it will be like, and a vulnerability about losing their skills etc. Those who remained at work may feel that those on furlough had the ‘easier option’ or feel resentment at not having been given the same option to go on furlough. These are just two sentiments raised from employees during our conducted Occupational Health consultations. 

Our list of examples and scenarios outlined are not exhaustive; and we understand that as people we all have specific needs which may be different to others. 

We hope that you found the suggestions we have outlined useful, especially in ensuring a smooth transition for those returning, and ultimately an emphatic and supportive working environment for all. 

If you require support from our Occupational Health department, you can find more information here.

Or to make an enquiry, please email us at info@fleetstreetclinic.com.

Choosing the Right Corporate Healthcare Programme

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Spotlight on our new laboratory

07.06.2021 Category: Clinic News Author: Dr Richard Dawood

Our new, in-Clinic PCR laboratory is now open: Introducing Fleet Street Laboratory.

Our historic Grade II listed premises have been adapted to accommodate one of the latest and most technically advanced robotic PCR systems anywhere, enabling us to carry out more tests simultaneously, accurately, and delivering the fastest results. Our lab upgrade means we will also continue to meet the highest quality and safety standards.

PCR technology is not new, but until recently hasn’t needed the space, complexity and resources of a full-scale clinical laboratory. Our upgrades mean samples can be processed in large batches rather than individually run.

In 2017, we embraced the challenge of bringing PCR closer to the consulting room: a pioneering colleague in the US had begun to use PCR at “point-of-care”, and I’d seen the benefits to patients first-hand. The Fleet Street Clinic became one of the first practices in the UK to apply this to respiratory infections, and also to gastrointestinal infections in returning travellers at our busy Travel Medicine practice. This enabled us to confirm a diagnosis and start treatment all at the same initial visit.

PCR stands for “polymerase chain reaction”.

It is a laboratory technique that exponentially amplifies the tiniest traces of any genetic material – DNA and RNA – that exactly matches the infection or disease under test. Instead of hunting with microscopes, or incubating cultures for days at a time, viruses, bacteria and parasites can be found quickly and reliably.  They can be sought individually, or in “syndromic panels”: a respiratory panel, for example, can screen a sample for an array of 22 different organisms at the same time, each capable of causing respiratory symptoms, detectable from a nasal swab.

By the time SARS-CoV-2 reached the UK at the beginning or 2020, we were onto our second generation of point-of-care PCR systems. We had just added two faster and more efficient machines, adding a panel of sexually transmitted infections to the repertoire (and capable of delivering a full sexual health screen in a couple of hours rather than the 2 to 3-day turnaround that our outside lab was offering). Both were quickly “upgraded” to be able to detect coronavirus infection – and when I contracted a mild version at the beginning of March 2020, my sample was our first in-house positive case. Within a couple of weeks, demand for consumables overwhelmed supplies, and we were left with equipment that was impossible to use.

One year on, we have dramatically expanded our capacity and capabilities. We have four sophisticated PCR systems, each with different strengths and capabilities, to which our newest system will now be added. We have been able to support some of the most challenging requirements: from clinical diagnosis (including support for the NHS) to facilitating international travel; and workplace screening for critical industries and complex projects – including major film production in the UK and abroad. Our focus has been on combining high quality service with the fastest possible turnaround. We have built expertise, developed our team, and are very excited about our new lab.

Come and see it next time you come to the Fleet Street Clinic!

Or if you need a PCR test, you can book online.

Fleet Street Clinic receives UKAS ISO 15189 Accreditation

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Have you had your flu jab?

01.06.2021 Category: Flu Jabs Author: Dr Richard Dawood

Flu jabs are a necessary part of Flu prevention… even after Covid-19

Flu vaccinations become available mid-September each year. They offer the best protection against the flu and are designed to be had prior to exposure to the flu virus. Like all vaccinations, immunity can take up to 2-weeks following vaccination to become effective so the earlier you get vaccinated the better.

Flu is still something we should be vaccinated again as it can be serious and lead to complications that can prove fatal. Vaccination offer protect for you, your family, your work colleagues and also those most vulnerable in your community.

The successful Covid-19 vaccination campaign has clearly demonstrated how vaccinations can protect the vulnerable and limit outbreaks. I hope everyone will learn from this and take full advantage of flu vaccination next time it is offered.

What is the next flu season expected to be like?
We don’t really know what to expect. There was very little circulating flu virus during the 2020/21 season, which means that there will be less immunity within the general population and more people will be susceptible. To make things worse, if there has been less flu around – globally – it becomes harder to predict exactly which flu strains will be coming our way, and so more difficult to pick the best strains to include in next winter’s vaccines. It is dangerous to assume flu has disappeared due to the pandemic and Covid restrictions that are currently in place.

Booking your flu jab:

Private vaccination is available from September until February the following year. Due to coronavirus, we operate a booking system so we can manage the flow of patients being vaccinated in a safe way.

Click to book online

Opening Hours: Monday – Friday: 9am-5pm
Address: Fleet Street Clinic, 29 Fleet Street, London, EC4Y 1AA

Saving lives with FIT testing: early Bowel Cancer detection

08.01.2021 Category: Cancer Author: Dr Belinda Griffiths

How much would you pay to prevent bowel cancer?

£1,000? £500? £200? £100? Or just £45?

Everyone knows a friend or relative who has suffered from or unfortunately, died of bowel cancer. Also known as colorectal cancer, bowel cancer is the fourth most common cancer in the UK but the second biggest killer. More than 16,000 people die from bowel cancer in the UK every year. Similar to other types of cancers, bowel cancer is treatable and curable especially if diagnosed early.

The earlier it is detected, the greater the chance of survival.


However, the survival rate drops significantly as the disease develops. The optimal test for bowel cancer is a colonoscopy, but it is an invasive test which checks the lining of the bowel for cancer. Due to the invasive nature of this test, it usually happens following a positive screening result or if a person has multiple symptoms so as not to cause unnecessary discomfort is symptoms are say. related to another health issue. 

As bowel cancer symptoms are also indicators for a wide range of gastroenterological (digestive system) disorders, a simpler, non-invasive FIT stool test (faecal immunochemical test) can be the first step for patients with concerns and/or symptoms such as lower abdominal symptoms such as abdominal pain, rectal bleeding and/or a change in bowel habits prior to a colonoscopy. 

For those who are healthy with no symptoms, FIT screening is an important way of testing healthy people to see if they show any early signs of cancer. 

Bowel Cancer Screening 


It can be challenging to differentiate between patients with serious bowel disease such as bowel cancer, from those with benign functional or diet-related conditions, such as IBS – irritable bowel syndrome, and minor colorectal diseases such as haemorrhoids. 

A FIT test or faecal immunochemical test, looks for blood in the stool, an early sign of bowel cancer. It is a simple and effective non-invasive test.

If there is blood present, this can indicate the presence of abnormalities in the bowel, which over time may develop into cancer. Patients with a positive FIT result are then referred for further investigation by colonoscopy.

A FIT test does not diagnose bowel cancer, but it’s a simple way to find out if you need further tests. Introducing regular bowel cancer screening into your health checks will reduce the risk of dying from bowel cancer. 

Are all FIT Tests the same?


The short answer, no. 

The sensitivity of a FIT test to detect blood in stools can be adjusted to be more or less accurate. The lower the threshold, the more sensitive the test is to blood in the stools meaning the earlier abnormalities can be identified. 

Where you live in the UK dictates the FIT tests available to you, see below:

NHS Scotland:

Age range: 50-74 years – Automatic invite for screenings every 2 years / 75+ done on request
Blood sensitivity threshold: 80ug per g of stool

NHS England & Wales:

Age range: 60-74 years – Automatic invite for screenings every 2 years / 75+ done on request
Blood sensitivity threshold: 120ug per g of stool

Fleet Street Clinic:

Age range: Screening recommended from 40 years onwards. Available from 20 years if symptoms are present and for individuals with a family history of bowel cancer of one or more first-degree relatives (sibling, parent or child).
Blood sensitivity threshold: 20ug per g of stool.

A big difference!

Why is this so important?


If early detection is a matter of life and death when it comes to bowel cancer then the optimum FIT test has to have the lowest sensitivity threshold to provide the most accurate diagnosis. The more sensitive the FIT screening, the more cancer and precancerous polyps can be detected, especially at an early stage of abnormality.

At Fleet Street Clinic, we are more likely to pick up blood in the stool by a factor of 4 compared to NHS Scotland and by a factor of 6 in comparison to NHS England & Wales, all without the rigid age limitations. 

Bowel Cancer Screening at Fleet Street Clinic


The FIT test at Fleet Street Clinic has the lowest sensitivity threshold on the market right now. It is an easy, quick test which costs just £45.85* with results within a week.

Surely it is worth it?

If by any chance your test is positive, we provide a letter of referral which can be given to your GP (Private or NHS) or used at one of the referral centres we recommend for private colonoscopy. The choice is yours.

Tell your friends about this life-saving test and save a life – It could be your own.

If you’re concerned about bowel cancer, then it’s important to book a 15-minute GP appointment to speak to a doctor – you can book online.

 


* A 15-minute GP appointment costing £85 is required in addition to the cost of the FIT test.

Statement on the new Coronavirus Strain

22.12.2020 Category: Covid-19 Author: Dr Richard Dawood

Following the confirmation of the new variant of coronavirus found in the UK, we have taken many enquiries regarding our PCR testing technology at Fleet Street Clinic and its ability to detect this new variant.

Please feel assured that our suite of Covid-19 rt-PCR detection equipment can confirm the presence of this new variant alongside the previously known strain.

We understand identifying this new variant of SARS-CoV-2 may cause concern due to its higher rate of infection compared to the previous known strain. However, rest assured, there is no evidence to suggest it causes more serious illness or would disrupt the effectiveness of the Covid-19 vaccine.

Prof Calum Semple, a member of the Scientific Advisory Group for Emergencies (Sage) which advises the UK government, said the new strain is likely to become the dominant global strain and it is therefore important our equipment is able to adapt to change to identify mutations to the SARS-CoV-2 virus.

At Fleet Street Clinic, we have developed a comprehensive portfolio of COVID-19 diagnostic testing solutions including multiplex rt-PCR detection and antibody testing and are able to provide rapid test results for diagnosis and travel purposes. This positioning hasn’t changed since this new strain has emerged. We pride ourselves on constantly adapting to meet the challenges of the Covid-19 pandemic and will continue to do so should any further genetic variations be identified on the SARS-CoV-2 genome.

For more information about our Covid-19 testing options, click here.

Coronavirus (COVID-19) News Update

19.05.2020 Category: Covid-19 Author: Dr Richard Dawood

Covid-19 Statistics:

UK: Public Health England
Worldwide: The Johns Hopkins Center

 

Coronavirus Testing:


Covid-19 testing is available at Fleet Street Clinic, including PCR testing for active infection, antibody testing for confirmation of past infection and PCR testing for travel purposes including travel certificate.

Samples can be collected in-clinic, during a home from the nurse or using a self-sample home testing kit.

For more information:

Alternatively, please call our reception team on 020 7353 5678 to see which option is most appropriate for your current circumstance.

Virtual GP Appointments:


If you have symptoms of coronavirus (a high temperature or a new, continuous cough), please do not leave your home. That includes coming into the clinic, any other GP surgery, a pharmacy or a hospital.

We’d suggest you can book a virtual GP appointment with one of our doctors. You can discuss your health concerns and symptoms by telephone or video call.
Alternatively, you can use the NHS 111 online coronavirus service. If you are experiencing life-threatening symptoms, always call 999 for an ambulance.

If you have symptoms you should self-isolate for 7 days. If you live with someone who has symptoms, you’ll need to self-isolate for 14 days from the day their symptoms started. This is because it can take 14 days for symptoms to appear. More details about self-isolation can be found here.

For further information about coronavirus (COVID-19) or read answers to common questions about it.

How to stop the spread of Coronavirus:


  • Wash your hands with soap and water often – do this for at least 20 seconds
  • Use hand sanitiser gel if soap and water are not available
  • Wash your hands as soon as you get back home
  • Cover your mouth and nose with a tissue or your sleeve (not your hands) when you cough or sneeze
  • Put used tissues in the bin immediately and wash your hands afterwards
  • Do not touch your eyes, nose or mouth if your hands are not clean

Recommended information sources:


Gov.uk: For the latest guidance about coronavirus (COVID-19) for health professionals, businesses, schools and other organisations.

Public Health England: For the latest information about the situation in the UK, along with guidance for what to do if you think you’re at risk. You can sign up for email alerts from PHE concerning coronavirus updates here.

NaTHNaC: For travel health advice for travellers to countries/areas affected by COVID-19

World Health Organization (WHO)

__________________________

Our Medical Director and Travel Specialist Dr Richard Dawood, has been at the forefront of the conversation, sharing insight and opinions as the pandemic unfolds:

2021:

The Telegraph: Vaccine passports for travellers ‘unavoidable’

The Guardian: Vaccine passports ‘essential’ for resumption of international travel

The Sun: Covid vaccine questions answered – from when you can hug again to delaying 2nd dose

iNews: Can I go on holiday in 2021? How UK travel restrictions and hotel quarantine affect booking summer holidays

2020:

Times letters: Strategy for combating the coronavirus

The Telegraph: Staycations to face masks – 5 ways coronavirus could change the way we travel

The Telegraph: Why flying can make you ill – and how to stay healthy on board a plane

CNN Travel: Travel and the coronavirus pandemic: Everything you need to know

CNN Health: 7 of your latest coronavirus questions, answered

Express: Coronavirus: When will it end? Experts reveal if virus could die off in warmer weather

Express: Coronavirus protection: Best way to prevent the deadly virus spreading through the eyes

2019:

Mirror: Everything you need to know about flu jabs and why you should get one before Christmas

 

Please note: All information stated is correct at time of posting.

Statement on Coronavirus: Service updates

30.03.2020 Category: Clinic News Author: Dr Richard Dawood

We are hoping you and your family are keeping safe and healthy.

We want to reassure you that we are committed to looking after your health during these trying times.

We have every intention of remaining open so you can access all of our services, however, we have had to make some necessary changes to adapt to the current circumstance.

Temporary Opening Hours:


We have made the difficult decision to temporarily adjust our opening hours. Starting Monday 23rd March, for the foreseeable future, the clinic will be open 9:00am – 5:30pm for face-to-face appointments – we may be able to facilitate virtual clinic appointments outside of these hours.

Virtual Clinic Offerings:


With many of you now working from home outside of London, it makes sense to adapt our services to meet your new needs.

You’ll be able to access a lot of our services through our virtual clinic from Monday 23rd March:

  • GP appointments
  • Travel consultation for health advice only
  • Repeat prescriptions

We are confident that this will not affect the quality of service that we will continue to supply to you.

Reduced Services:


We are running a reduce service for optical appointments. We advise you call our front of house team on 020 7353 5678 to make any appointments or alterations.

Booking An Appointment:


To protect the health and wellness of our patients and our team, we’ve decided to turn off online bookings for the time being. Rest assured you can still book appointments, however, this now needs to be done through our friendly reception team on 020 7353 5678 to determine if a face-to-face appointment or virtual consultation is required. Due to reduced availability, a deposit is required for all appointments.

Getting in touch:


Due to these unprecedented circumstances, we’re experiencing an increase in phone calls so you may have noticed our call waiting times have been slightly longer than usual. Our reception team are working at full capacity to offer reassurance and to book your appointments, however, please do not hesitate to email us if the phone line is too busy. We will answer all enquiries we receive.

Prescriptions for Medicines & Contact Lenses:


Please note, you can place orders for repeat prescriptions and contact lenses in advance via email here.
Outline your medicine needs and/ or your contact lens prescription and you can either pick your prescription up from the clinic or we can dispense these directly to you via the post.

Feeling unwell?


We would kindly like to remind you that you must not come to the clinic if you are suffering from any of the symptoms below:

  • Coughing
  • Sneezing
  • Running nose
  • Sore throat
  • High temperature
  • Shortness of breath

We are not offering testing for COVID-19 at our clinic but will be sure to keep you informed if this is to change.

Our commitment to our patient’s health and well-being remains our primary focus and we will continue to work safely and strategically during these unprecedented times. If there are any developments that impact these arrangements, we will notify you at the earliest possible opportunity.

Thank you for your support in keeping one another safe.


For more advice on Coronavirus…

Save the Children

02.12.2019 Category: Charity Work Author: Lisa-Marie Ryan

On Friday 14th December 2019, The Fleet Street Clinic, along with thousands of people up and down the UK will embrace their craziest & tackiest Christmas jumpers in celebration of Christmas Jumper Day, to raise money for Save the Children.

Save the children, are a fantastic charity who help some of the world’s most vulnerable people, which is why we choose to support them every year.

Save The Children began Christmas Jumper Day with the aim of “making the world better with a sweater”. While it’s an undoubtedly fun and light-hearted occasion, the main focus of the day is to highlight the lifesaving work the charity does. They help bring essential food, healthcare & education to many children who are, for many reasons, currently missing out.

Save the Children aims to create a world where every child survives, learns and is protected. Child poverty, hunger, education and health are just a few of the charities key aims which help children who live in some of the toughest places in the world.

As a healthcare provider, ensuring all children throughout the world have access to health care is extremely important to us. There is a danger that children are being left behind because they are poor, because they are girls or because of their ethnicity.

Last year, Save the Children helped 10.6 million children through their health and nutrition work. This year they plan to help many, many more!

___________________

How can you get involved?

The simplest way of getting involved with Christmas Jumper Day is to join in!

Wear your most eye-catching Christmas jumper and donate some money towards Save the Children.

Make a difference this Christmas!

Movember – Championing Men’s Health Issues

Read more

Travel Tips Thursday - Philippines

19.11.2019 Category: Travel Health Author: Anna Chapman

The Philippines is a fascinating archipelago, made up of thousands of islands where you can explore stunning beaches and enjoy superb surfing and diving.

Ensure you follow our top travel tips to stay healthy.

7,641 islands,  of these islands, only 2,000 are inhabited.

The Philippine archipelago is divided into three island groups: Luzon, Visayas, and Mindanao.

Vaccinations

If you are heading to the Philippines you should ensure that you are up to date with your routine immunisations.  There have been outbreaks of measles and polio this year in the country so all travellers should ensure they have received 2 doses of the MMR vaccination and a full course of diphtheria, tetanus and polio (DTP) vaccinations.

In addition, it is advised that vaccinations against hepatitis and typhoid are given. Other vaccinations that can be considered are hepatitis b, rabies and Japanese encephalitis. Find out more about our wellness and travel vaccinations.

Rabies

Rabies is an especially high risk in the Philippines. It is a virus found in the saliva and bodily fluids of mammals. It is transmitted to humans by the bite, scratch or lick to open skin. Once the virus enters the body and the nervous system, it is fatal. There is a large number of stray animals in the Philippines so extra care should be taken to avoid contact with animals. Pre-travel rabies vaccinations are strongly recommended for travellers to the Philippines.   There have been reports of falsified rabies vaccinations and immunoglobulin circulating in the country meaning anyone exposed to the virus seeking medical treatment in-country may not receive the proper treatment.

Malaria

The majority of the Philippines is low to no risk of malaria.  Palawan, Tawi Tawi, Zambales and Zamboanga del Norte present a higher risk of malaria. Most travellers will not require anti-malarial medication providing they are careful not to get bitten by mosquitoes. The malaria mosquitoes are most active during the evening, so if you plan to visit a high-risk area, ensure you are cautious between the hours of dusk and dawn and aim to sleep under a mosquito net to prevent bites whilst you sleep.

Insects

The Philippines has a risk of several non-vaccine preventable viruses that can be spread by mosquitoes. Dengue fever, chikungunya and zika virus are the main culprits. These viruses are spread by mosquitoes that predominantly bite in the day. As there is no vaccination nor medication that will prevent this illness, strict precautions must be taken to prevent their bites. Wear long loose clothing and cover up as much as possible, particularly between dawn and dusk. Wear a good insect repellent with a minimum of 50% DEET in it, and treat clothes with the insecticide permethrin for added protection.

The Philippines Department of Health (DoH) declared a national dengue epidemic on 6 August 2019. Continue to follow NaTHNaC advice and take precautions to avoid being bitten by mosquitoes

See our ultimate bug kit.

Water sports

The Philippines is made up of over 7000 islands and the main way of reaching them is by boat.  If you are prone to travel sickness you may want to ensure you pack some medication to prevent this so not to interrupt your experience.  There is an abundance of pristine coral reefs throughout the archipelago making the country perfect for water sports.  Whether you are snorkelling, surfing or scuba diving, if you plan to take the plunge you need to be careful to avoid coral cuts and abrasions. Extra care needs to be taken with coral cuts to prevent them from becoming infected. Packing a small first aid kit with tweezers, waterproof dressings and antiseptic is a sensible idea.

The availability of medical care varies across the Philippines, and may not meet the standards of care in the UK. Although adequate in major cities, medical care is limited in more remote areas.

Book your travel appointment today

By Anna Chapman |  Travel Nurse | November 2019

Travel Tips Thursday - Myanmar

19.11.2019 Category: Travel Health Author: Anna Chapman

Myanmar is becoming an increasingly popular destination to visit in South-East Asia.

The golden pagodas of Yangon and the stupors of Bagan are top on most travellers itineraries, alongside a trip down the Irrawaddy river to Inle Lake.

The more adventurous may head to the islands on the Myiek archipelago or hike the hill station of Kalaw. Whatever the itinerary, it is essential to ensure you have sought pre-travel advice to ensure you stay healthy whilst abroad.

Vaccines

Travellers should ensure they are up-to-date with their routine immunisations. All travellers should ensure that they have received a vaccination against diphtheria, tetanus and polio (DTP) in the last 10 years. Other vaccinations that all travellers should ensure they are up-to-date with are Hepatitis A and Typhoid. Some travellers may wish to consider vaccination against hepatitis b, rabies, cholera and Japanese encephalitis. It is best to book a travel consultation with a travel nurse to discuss your route and your plans to ensure you are protected for all circumstances.

For more information on our vaccines, please visit our travel and wellness vaccination pages.

Malaria

The cities of Yangon and Mandalay have no risk of malaria. The majority of areas that travellers visit such as Bago, Inle Lake, Kyaikto Padoga and Bagan have a low risk of malaria and anti-malarial medication is not usually advised. The states of Chin, Kachin, Kayah, Rakhine and Sagaing have a high risk of malaria. Travellers visiting these areas are advised to take anti-malarial for this part of their trip. The malaria mosquitoes are most active during the evening. So, if you plan to visit a high-risk area, ensure you are cautious between the hours of dusk and dawn. Aim to sleep under a mosquito net to prevent bites whilst you sleep.

Insects

Myanmar has a risk of several non-vaccine preventable viruses that can be spread by mosquitoes. Dengue fever, chikungunya and Zika virus are the main culprits. These viruses are spread by mosquitoes that predominantly bite in the day. As there is no vaccination or medication that will prevent these illnesses, strict precautions must be taken to prevent being bitten. Wear long loose clothing and cover up as much as possible. Particularly between dawn and dusk. Wear a good insect relevant with a minimum of 50% DEET in it. Treat clothes with the insecticide permethrin for added protection. For short adventures, this can be done before your trip.

See our Ultimate Bug Kit.

Fancy a dip in Lake Inle?

Think again. Temperatures in Myanmar can reach 40 degrees and a quick dip in the lake may sound like a good way to cool off. However, there have been recent outbreaks of schistosomiasis infection in Myanmar. Schistosomiasis is a parasitic blood fluke. The fluke lives in freshwater snails and enters through the skin when an unsuspecting person takes a dip. The fluke causes infection of the liver, bladder and bowels and can lead to long term damage. The best way to avoid this is to avoid swimming or bathing in freshwater. The detection of schistosomiasis can take up to 8-weeks. You should visit a GP for a health assessment 2 months after your suspected exposure date, even if you haven’t yet returned to the UK.

First Aid

Some areas of Myanmar are remote. The further in-country you travel, the harder it will be to access medication and first aid supplies. In some areas, access will be non-existent. Packing a good basic first aid kit is essential to help treat minor injuries and illnesses. Include items such as dressings, plasters and antiseptic cream. They can help with minor cuts, scrapes and blisters. It is useful to pack items that can alleviate pain and treat upset stomachs, as these are common traveller’s health problems. Another medical kit you may want to consider is a worldwide gastro kit. Other items you may want to consider are anti-histamines for any mild allergic reactions.

If you take prescription medication to ensure you pack sufficient for your trip and carry a record of the medication with you.

Book your travel appointment today

By Anna Chapman |  Travel Nurse | November 2019

Winter Nutrition Advice

01.11.2019 Category: Dietitian Author: Ruth Kander

How to Stay Healthy This Winter

When the temperature drops outside, it’s tempting to reach for comforting, high-calorie food and avoid exercise. Feeling cold, along with short days and weight gain can lead to the onset of Seasonal Affective Disorder or depression in the winter months.
Fleet Street Clinic’s Consultant Dietitian, Ruth Kander BSc (Hons) gives some practical advice on what you can do to avoid the winter blues.

Consume a Variety of Foods

By eating foods from all the food groups, you will have all the nutrients you need to stay healthy and keep winter germs at bay whilst maintaining your energy levels.

Eat Plenty of Fruits and Vegetables 

These will give you vitamins and minerals to help your body fight winter bugs. Vitamin C is especially beneficial in the fight against colds and sore throats.  Avoid taking supplements which contain high concentrations of vitamins which can lead to medical problems. Fruit and vegetables high in vitamin C include kiwi, citrus fruits, spinach, pumpkin and sweet potato. Zinc is also a good mineral to help fight winter infections and boost the immune system. Foods containing zinc include fish, oysters, poultry, eggs, milk, unprocessed grains and cereals. If you’re short on time, using a blender to create a vegetable and fruit drink is a great way to pack your diet full of vitamins. Try combining lettuce, cucumber, spinach, ginger, berries and a dash of orange juice and water for a zingy, low-sugar start to the day.

Keep the Pantry Cupboard Well Stocked

Good foods to store include:

  • Tinned beans and lentils
  • Tinned tomatoes
  • Whole-wheat pasta
  • Brown rice
  • Couscous and noodles
  • Wholegrain cereals – for example, Porridge and Weetabix

Plan Your Meals

Make soups and casseroles in advance and freeze. That way you can come home to a nutritious meal in the evenings. Simply take out of the freezer in the morning so that they are ready to heat up after work.

Watch Portion Sizes 

To avoid eating too many carbohydrates, try eating your meals at the table with the TV turned off, use smaller plates and reserve half your dinner plate for vegetables. If you want more after your first serving, have some soup or more hot vegetables.

Stay Active

It’s tempting to reduce your exercise regime in the colder months. But small efforts can go a long way to help stave off winter weight gain. Going for a regular, brisk walk or using an exercise video at home can be enough to maintain your weight and stay healthy over the winter.

Drink Plenty of Fluids

Try to avoid getting dehydrated. This can make you feel overly tired and unnecessarily run down. Drink plenty of fluids throughout the day that are either low calorie or calorie-free – aim for 2 litres a day. Be aware that your daily hot drink from the coffee shop can contain 360 calories or more!
Looking for an alternative to still water? Try green tea, regular tea, herbal teas, regular coffee, hot no added sugar cordial or lemon water.

Consult Fleet Street Clinic

Ruth Kander holds a virtual clinic every Friday from 9am-2pm for individual dietitian consultations and ongoing weight management courses. Please call our reception team on 020 7353 5678 if you would like to request a face-to-face appointment

Book Your Dietitian Appointment with Ruth

How to look after your Winter Feet in the cold weather

28.10.2019 Category: Podiatry Author: George Hill

WINTER FEET – LOOKING AFTER YOUR FEET IN COLD WEATHER

ADVICE FROM OUR PODIATRIST, George Hill

Staying warm when it’s cold outside can be a challenge. Especially when it affects our body’s circulation; our feet and hands can suffer especially. In cold weather, it is a natural response to prioritise the heating of our vital organs. This is so they remain at their optimal temperature for full functionality. This means having cold feet is normal when the temperature drops. Nail growth slows down and skin will often become drier because nutrition to these tissues is affected.
In response to this temperature change, small blood vessels temporarily constrict. As a result, you may see a change in the colour of your skin, which could look pale, blanched and waxy at first, before becoming bluish. This is because the oxygen in the blood has been used up by the tissues. The skin is also cool to touch. Returning to warm conditions usually remedies this and the skin becomes pink and warm again.
However, in some individuals, this response is exaggerated and prolonged. This condition is known as Raynaud’s phenomenon and can be inherited. The same response will occur but much more readily and will last longer. Meaning the colour changes are much more obvious. When the skin is deprived of oxygen for long periods of time, some injury occurs to the soft tissues. This can make fingers and toes numb while they remain cold. When the blood vessels do finally relax and blood returns to the area, fingers and toes can throb and burn, turning bright red with inflammation. Eventually, things return to normal but repeated episodes of this can lead to dry, devitalised skin and changes in nail shape and texture.

Chilblains occur for much the same reason. These are painful, itchy swellings that often occur on the tops of small toe joints but can occur in other bony areas too, such as the back of the heel. Tightly fitting footwear can add to the misery by constricting blood flow further and rubbing on the painful skin. Chilblains are not caused by using hot water bottles, as commonly thought, they are a cold injury to Winter Feet, The attempt to relieve the intense itch by scratching merely worsens the problem, often causing further damage. Itching tends to break the skin and causes sores which can sometimes lead to infections.
Preventative action should reduce the likelihood of chilblains developing, but if they do, an antipruritic (anti-itching) cream or ointment can be obtained from pharmacies, and menthol-based products can also be very soothing.
If the skin becomes broken, antiseptic creams such as Savlon help the skin to heal and prevent infection. Cover with a gauze pad after applying, which can be secured with finger bandage or held in place with a cotton sock.
In the aftermath of chilblains, the affected skin is often dry, thin and rough, so use a moisturising cream to restore normal texture.

Cold feet at night can keep you awake or disrupt sleep.
What can be done to help? If you are susceptible to cold extremities, it is important to keep yourself generally warm. Listen to the temperature forecasts and dress accordingly. As well as suitable outer clothing, trousers, tights or socks will help to keep the whole limb warm. Fibres such as wool or bamboo are good insulators and several light layers, rather than one thick layer, traps more air and heat. Remember to wear roomier footwear to allow for thicker socks without compressing the skin.
Footwear should have a good rubber or composite material sole, to insulate against cold pavements – adding insoles of cork or lambswool can improve insulation and comfort. The sole should have good grip for traction on slippery pavements.
Keep active – this improves circulation, and have plenty of hot drinks and food throughout the day.
At home, a warm (not hot) foot-bath will help. Dry with a rough towel and apply a cream or lotion with a massaging action. Some preparations include ingredients such as capsaicin or ginger, to stimulate circulation. Afterwards, put on loosely-fitting, warm socks or slippers to maintain the effect. If the feet are warm before going to bed, they are likely to stay warm. Bed socks in wool or cashmere can be very helpful. Water bottles or gel pads should not be over-heated, as sensation can be unreliable in cold feet.

People who suffer from eczema will find that cold weather tends to make the skin even drier and more cracked. Use plenty of ointment to keep the skin well hydrated and wear hose to help trap moisture and warmth. Silk is a good choice of material and is thin enough to wear under a thicker, outer sock.
In severe cold weather, you may find you get recurrent problems in your feet. Consult your GP who may advise a prescription drug to relax the constricted vessels and thus improve blood flow to the extremities.

Book Your Winter Feet Podiatry Appointment

For more information about podiatry at Fleet Street Clinic

Travel Tips Thursday - Botswana

19.10.2019 Category: Travel Health Author: Anna Chapman

Botswana is one of the greatest safari destinations.

The Okavango Delta offers exceptional opportunities to view wild creatures and birdlife. Elephants roam freely and herds of buffalo crowd around the winding waterways the river. The stark and desolate landscape of the  Kalahari desert can be found in the south with the longest unbroken stretch of sand there is. Whatever your itinerary, ensure you follow our top travel tips.

Vaccines

All travellers should ensure they are up-to-date with their routine vaccinations including measles, hepatitis A, typhoid, diphtheria-tetanus and polio (DTP). You may want to consider getting vaccinations for rabies and hepatitis B as well. Both these diseases are classed as high-risk in Botswana. We would advise you to speak with a travel nurse ideally 4-6 weeks before travel. At this appointment, you can discuss where you’re going and what you plan to do. They can then advise you of all the recommended vaccinations you should consider.

Find out more information about our travel and wellness vaccinations.

Malaria

There is a high risk of malaria throughout the year in the northern areas of Botswana including the Okavango Delta, Chobe and Moremi. There is a low risk of malaria in the rest of the country including the central Kalahari, Gaborone and Gemsbok. Individuals travelling to hight risk regions are advised to take anti-malarial medications to prevent the disease. As well as taking precautions against mosquito bites. The mosquitoes that spread malaria predominantly bite at night. For that reason, it is essential you sleep under a mosquito net.

Insect prevention

All travellers need to take extra precautions against insect bites. Mosquitoes, ticks, mites and lice are able to spread diseases such as African tick bite fever, dengue fever, filariasis and myiasis. Travellers should wear good insect repellent with at least 50% DEET and try to cover up with long loose clothes. You can add extra protection to your clothes by treating them with an insecticide. We would recommend using a permethrin spray.

See our Ultimate Bug Kit.

What about Yellow Fever?

The is no risk of Yellow Fever in Botswana. It is therefore not recommended that travellers get vaccinated. Travellers may require a valid Yellow Fever Certificate if they are entering Botswana from a country that has yellow fever, or who have transited through a country with a risk of yellow fever.

First Aid Supplies

Areas of Botswana can be remote, and access to medication and first aid supplies can be limited. Packing a good basic first aid kit is a good idea to help treat minor injuries and illnesses. Basic items such as anti-histamines, pain relief and medicines to treat upset stomachs are useful. Likewise, pack small dressings, plasters and antiseptic cream to treat minor scrapes and scratches. If you take prescription medication to ensure you pack sufficient for your trip and carry a record of the medication with you.

Book your travel appointment today

By Anna Chapman |  Travel Nurse | October 2019

How Can You Exercise More? Get Outdoors

22.09.2019 Category: News Author: Lisa-Marie Ryan

Exercise More – Get Outdoors

Today is National Fitness Day. September is a great time to redress the balance after summer holidays and make a new exercise plan.  Time to get out and get moving!

Regular exercise has many benefits – a healthier heart, increased well-being, and a better quality of life. Research shows that if you exercise with friends, you are more likely to continue to keep fit, as the social environment encourages positive associations with the activity.

Exercising outdoors can contribute to this feeling of wellbeing. Organised outdoor exercise groups have grown in popularity recently, with a wide range of community-based activities across the country. A few of the more popular outdoor exercise activities are detailed here:

Park Run – Over 1 million Britons have taken part in Park Run – the Saturday morning 5k run in local parks across the country.

Project Awesome –  A free community exercise group based in London, Bristol and Edinburgh, Project Awesome is based on high-energy, early morning exercise classes designed to kick-start your day.

Good Gym –  For those who’d like to combine voluntary work with exercise, Good Gym enables you to meet like-minded people to run and work together on community projects in your local area.

British Military Fitness – Operating in parks across the UK,  British military fitness classes are run by serving or former members of the armed forces with recognised fitness training qualifications. Classes are graded by ability group and are for members of the public. They are designed for all abilities, from those just starting to exercise who want to lose weight, to the already very fit.

Open Air Swimming – If you’re a keen swimmer, have you ever tried swimming outdoors? There are many reported benefits to open-air swimming, which can be enjoyed all year round even in the UK, with or without wetsuits. Check Wild Swim for your nearest open-air swimming site.

Getting Fit with Fleet Street Clinic

Our podiatrists can offer advice on appropriate footwear for exercise and our dietician and osteopath can work with you to support your exercise regime, ensuring a holistic approach to achieving a long-term, healthier you.

Travel Tips Thursday - Albania

19.09.2019 Category: Travel Health Author: Anna Chapman

Albania, located in Southeastern Europe, is a tourist haven this time of year.

Albania has much to offer, from stunning mountain scenes to crumbling castles to picture-perfect beaches all with easy-going charm and a friendly atmosphere. Right now the tales of its beauty haven’t quite reached the masses, but we have a feeling this is likely to change in the not too distant future.

If you plan on staying in Albania‘s capital, Tirana, be sure to see the rotating restaurant/ bars for spectacular city views.  Or take to the countryside and seashores to take in the ubiquitous sight of the abandoned concrete bunkers of Albania. Fearing invasion during the Cold War, Albania’s leader Enver Hoxha forced his country to build tens of thousands of bunkers throughout the country. These days you’ll see most in a state of slow decay but some have been given a new lease of life as a hotel, home or museum.

Visit Berat, to see the ‘town of a thousand windows’. This fascinating city dates back to the Ottoman Empire. The most striking feature of Ottoman architecture is the collection of whitewashed houses and towering minarets which adorn the hill to its castle. It is easily a highlight of visiting Albania. If, however, you prefer the great outdoors scale the peaks and troughs of the Accursed Mountains and take in the captivating castles of Gjirokastra.

Whatever your plan to do, be sure to follow our top travel tips to stay healthy in Albania.

Routine Vaccinations

All travellers to Albania are advised to be in-date with their routine immunisations. These include diphtheria-tetanus and polio and measles, mumps and rubella. Europe has seen huge outbreaks of measles in recent years. Therefore, all travellers should make sure they have received at least two doses of the vaccination, MMR.

If you’re unsure of your immunity, you can have a simple blood test to find out. Some travellers may wish to consider vaccinations for Hepatitis A and Hepatitis B, Rabies, and Tick-Borne Encephalitis. It is best to book a pre-travel consultation with a travel nurse to discuss your holiday plans. Together you can discuss what vaccines you’ll need.

Trekking and Ticks

The dramatic peaks of the Accursed Mountains spread their spoil between Kosovo, Albania and Montenegro. Those who plan to take advantage of the great outdoors should strongly consider vaccination against tick-borne encephalitis (TBE). TBE is a bacterial infection spread via tick bites or the consumption of unpasteurised dairy produce (between spring to autumn). Contracting the illness causes a fever with neurological complications.  

TBE is vaccine-preventable and consists of 2 doses of the vaccination being given at least 2 weeks apart.  A third dose is given 5-12 months later to give longer-term protection. Travellers should also avoid ticks by wearing long trousers and socks, and using DEET insect repellant. If you spot a tick on you, it needs to be removed promptly with some flat tweezers or a tick remover and cleaned with alcohol to reduce the risk of infection.

Rabies

Rabies is a fatal virus found in the saliva of infected mammals. Travellers can be exposed to it through a bite, scratch or a lick to an open area of skin.  Therefore, you should avoid contact with animals, especially wild and stray animals. The vaccination against rabies means that treatment can be given easily and in the country should a risk of rabies occur.

You will require a series of 3 vaccinations to be given over a 3 week period. Or over 1 week if a rapid course is needed. Travellers at greater risk are those who plan to do outdoor activities such as hiking, trekking, cycling or caving.

For more information on our vaccines, please visit our, travel and wellness vaccination pages.

First Aid Kit

For those trekking in the hills, packing good basic first aid kit is essential. The availability of health care and first aid supplies are very limited in rural areas, particularly outside Tirana. Therefore, you should make sure you bring your own adequate basic provisions. These include pain relief, plasters and medication to treat an upset stomach, such as loperamide and oral rehydration salts. Cuts, scapes blisters and even a twisted ankle can occur, so take blister pads, some waterproof dressings and a bandage to deal with any minor injuries whilst you are there.

Access to safe water may be limited. You should consider packing chlorine dioxide tablets to purify your own water. Alternatively, you can purchase a water-to-go bottle which has a built-in filter. If you take regular prescription medication, be sure you pack enough to last your entire journey. And, remember to carry the prescription with you just in case.

Book your travel appointment today

By Anna Chapman |  Travel Nurse | September 2019

Podiatry: Pesky Verruca

04.09.2019 Category: Podiatry Author: George Hill

It’s now coming to the end of summer and many of us have spent plenty of time around pools and on the beach. Which can be wonderful, of course. However, bacteria and viruses can thrive in these locations causing foot infections.

George, our podiatrist talks about one in particular: the pesky verruca.

Verrucae are commonly found on the foot and are relatively harmless. However, there is the possibility they have other more sinister properties. Some can become malignant and/ or grow and spread across the foot causing a host of uncomfortable or potentially dangerous problems.

Verruca or Verrucae are caused by the Human Papilloma Virus (HPV). There are hundreds of different types of HPV and different strains infect the body differently. Some types infect the skin, causing verrucae. Even if you come into contact with the virus that causes warts, the risk of becoming infected and developing a wart is small.

Common warts and plantar warts are not usually a serious health concern. These viral warts have not been shown to play an aetiological role in wider known high-risk HPV-linked diseases* such as cervical cancer and Bower’s disease. This is due to HPV presenting as different strains. Having one does not mean you have the other.

*For additional information on HPV’s link to cervical cancer and HPV’s link to Bowen’s disease, we recommend Macmillan’s website.

Contrary to what the old wives tale would have you believe, warts are not caught from touching a toad. Viral plantar warts are in-fact contracted via skin to skin contact or surface to skin contact; among other suggested routes. While common warts are usually painless, plantar warts can be painful because they press inward when you stand on your feet. 

In appearance, these lesions are lumps that are generally circular in shape and appear slightly raised and can be callused over with thicker skin. Some will present with small black/deep-red specks, often noted as the capillary heads and others can be clustered into groups. If you have any small areas of skin you are concerned about then it is important to have these reviewed by your Podiatrist immediately.

Verruca Image from nhs.uk
Verruca Image from nhs.uk

For many, a verruca will disappear in a few weeks to months. However, if they do not it is likely you will require treatment to remove them before they grow or spread. Although one small verruca can be pain-free but unsightly, a large cluster can be quite painful to walk on. Adjusting your walk to relieve the pain can lead to further foot complications. So, it is best to take action as soon as possible.

Over the counter treatment options may work for some people. However, stubborn, persistent verruca will require more appropriate specialist treatment and observation. A medical professional should review all lesions. This is very important so to rule out more serious health concerns.

Specialised treatment is often provided with minimal pain with great results. High strength acid paste or cryotherapy using true liquid nitrogen can be the most appropriate methods for nearly all strains of verrucae. Your podiatrist will advise you on the best course of action based on the verruca presentation, your lifestyle and detailed medical history.

We advised you do not begin treatment without consulting a medical practitioner first. Your Podiatrist should be the first port of call when dealing with these pesky verrucae.

Book a podiatry appointment

For more information about our podiatry service, our foot health check-up, cryotherapy and medical pedicures.

By George Hill | Podiatrist | September 2019

Sexual Health and Travel

04.09.2019 Category: Sexual Health Author: Dr Belinda Griffiths

Holidays are a time to relax, unwind and have fun!

However, this excitement can lead to us making decisions we may not usually make when we are at home. If you have unprotected sex whilst abroad whether it is oral, vaginal or anal you are at risk of catching sexually transmitted infections.

You could be at risk of catching these common STIs:  HIV, chlamydia, HPV, herpes, syphilis and gonorrhoea.

What can you do to prevent an STI?

Abstaining from sex is the most reliable way to avoid infection. However, if you wish to be sexually active follow some of the tips below:

  • Use a condom from start to finish every time during sex including oral, vaginal and anal.
  • Get vaccinated to protect against diseases such as Hepatitis B and HPV.
  • Do not assume that your partner is STI-free. Talk openly and discuss your sexual health histories.
  • Taking drugs and/or alcohol can lead to bad decisions. Be cautious when having sex whilst inebriated as you are more likely to take risks. These include not wearing a condom or having sex with someone you usually would not.

What are the symptoms of an STI?

Symptoms are different depending on the infection. Some diseases also do not cause any symptoms which makes them very hard to spot. If symptoms do occur, they could be some of the following:

  • Pain when you urinate or have sex
  • Discharge from the vagina, penis, or anus
  • Unexplained rash, sore, or ulcer on your skin, genitals, or throat
  • Jaundice (yellow colour of the skin and eyes)

What do you do if you think you have an STI?

Having an open and honest conversation, discussing your sexual health with your doctor is a good start to help guide you towards any tests or medication that you may need.

Long-term problems can be prevented by testing for STIs early and also prevent the spreading to other partners.

If you are worried that you may have an STI you should:

  • Not have sex with anyone. This will reduce the risk of spreading the disease to anyone else.
  • See a doctor or nurse as soon as possible.
  • Discuss your sexual history and international travel with the doctor or nurse as some diseases are more common in some countries.
  • If you have a positive result notify your recent partners. They may also be infected and unaware.

Fleet Street Clinic offers a discreet and trusted sexual health service including confidential sexual health advice, instant testing, and comprehensive STI screening.

You can book a sexual health appointment online.

Why You Should Vaccinate Your Workforce Against Flu

27.08.2019 Category: Flu Jabs Author: Dr Richard Dawood

Have you thought about Corporate Flu Vaccinations?

The winter season can be problematic for businesses, as employees take time off due to sickness and annual leave. Illnesses such as flu are most likely to affect employees during the autumn and winter months.

If you are in charge of organising your company healthcare and wellbeing programmes, you may be unsure about whether to offer flu vaccines. The fact is, workplace flu vaccination can offer a significant return on investment in terms of reduced absenteeism and increased efficiency in the office, meaning there is one less thing to worry about.

We respond to some common questions about corporate flu programmes here:

WHAT TIME OF YEAR SHOULD I ORGANISE MY COMPANY’S corporate FLU VACCINATIONS?


Plan ahead and book the session as early as you feel able. This will ensure you’ll get the dates you want to suit your companies needs.

For best protection, the optimal timing for vaccination is between September and early December, before flu viruses begin to circulate. Each year, October and November prove a popular choice but we can vaccine up until February 2021.

WHY SHOULD I PROVIDE CORPORATE FLU VACCINATIONS FOR MY STAFF?


A flu outbreak in the workplace can cause an increase in absenteeism, which can result in a loss of productivity as well as increasing the workload of any staff that do not succumb to infection. For large and small organisations alike, this can have a massive impact on productivity and revenue. Furthermore, this year in particular, flu symptoms are extremely hard to distinguish between Covid-19. Getting the flu jab has become even more important than in previous years to eliminate potential confusion.

Workplace vaccinations are a great way of promoting health and wellbeing among your employees and demonstrating a caring ethos.

Benefits of the Flu Vaccine include:


  • Flu vaccinations improve the wellbeing of your employees, promoting job satisfaction and a positive work atmosphere.
  • Flu vaccinations reduce absenteeism.
  • The greater the number of people who are vaccinated, the less potential there is for flu to spread through your workplace, among staff members families, and within the local community.
  • Annual seasonal flu vaccination is the best way to reduce the chances of becoming ill with the flu.

HOW MANY PEOPLE TAKE UP THE FLU VACCINATION?


Workplace flu vaccination uptake can vary. Internal promotion and communication can make a big impact on likely numbers; motivation to avoid illness, and perception of current risk are also key factors. A good general guide, based on past years indicated an uptake of between 25%-45%. Due to more awareness of viral infections due to Covid-19, we anticipate this uptake to be higher this year and that given the option, most staff would probably choose to be vaccinated.

How Much Money Can You Save Your Company with a Flu Vaccine Programme?


Calculate the likely savings your company can make from a successful flu programme by visiting our corporate flu calculator here.

Fleet Street Clinic offers workplace flu vaccination programmes both on-site across the UK,  and at our drop-in clinic in central London, via our flu vaccination programme, FluJabs.Org.

Get in touch and make an enquiry if you would like more information or a you can get quote for your company.

Choosing the Right Corporate Healthcare Programme

Read more

Statement on the Yellow Fever Vaccine

26.08.2019 Category: Travel Health Author: Dr Richard Dawood

Yellow Fever Update:

Recent news reports have raised concerns about yellow fever vaccine safety. It is important to understand the risks and benefits.

For decades, the yellow fever vaccine was considered to be extremely safe. More recently, however, we have become aware of a low rate of serious adverse effects occurring when older travellers are vaccinated for the first time. The two main types of adverse effects are called YEL-AVD and YEL-AND – the first involves damage to organs such as the liver, and the second damages the nervous system. Yellow fever vaccines contain live viruses that do not harm people with a normally functioning immune system but do seem to cause harm in a tiny proportion of people with an ageing immune system, as well as those with reduced immunity from other causes.

In one of the largest medical studies of yellow fever vaccine safety, the rate of YEL-AND in people aged 60-69 was 2.5 per 100,000 people vaccinated, and in over 70s was 1.6 per 100,000. For YEL-AND, the rates were zero and 4.0 per 100,000 respectively.

According to the US Centers for Disease Control, in the absence of a yellow fever outbreak, the “background” risk of yellow fever occurring in unvaccinated travellers on a 2-week trip to a zone where yellow fever is present is calculated to be:

  • West Africa: 50 cases per 100,000, with 10 deaths per 100,000
  • South America: 5 cases per 100,000, with 1 death per 100,000

Yellow fever vaccinating centres normally explain these risks to everyone they vaccinate, and in particular to travellers aged over 60.  Vaccination for personal protection is recommended where benefit outweighs the risks, and a medical waiver is given when it is not safe for the vaccine to be used. Age alone is not a reason for issuing a waiver.

Other factors that complicate the picture include the following:

  • There are active outbreaks of yellow fever in several parts of the world, notably at present in Brazil as well as in several African countries, so the risk to travellers is often much higher than that quoted above.
  • Vaccination is the only way to prevent and control yellow fever and is often the only possible public health measure for entire populations.
  • Many countries therefore rigorously enforce vaccine requirements as a condition of entry.
  • Yellow fever vaccine shortages are common – there is currently a serious shortage in the USA, and the vaccine is not always available when needed.
  • Awareness of vaccine risks has come with a stricter approach to recommending vaccine only when travellers are definitely going to be at risk; however, an unintended consequence of this has been to delay the opportunity to vaccinate travellers for the first time until they are older and at greater risk of adverse effects.

The World Health Organization now considers vaccine protection to be life-long, though border officials in several countries do not always recognise this. A small number of recent cases of yellow fever in Brazil among people who had been vaccinated previously has raised further doubt about this policy, and Brazil currently recommends revaccination every 10 years.  Revaccination has not been linked to adverse effects.

There is currently extensive UK press coverage (that has also been picked up in the US) of YF vaccine adverse effects – one death occurred shortly after vaccination in a distinguished cancer researcher, and a psychotic reaction in a former BBC journalist vaccinated in Greece. Both cases were attributed to the vaccine because of the timing. Further clinical details are not available, so we can’t yet be certain of a direct link, but this news will undoubtedly have a considerable impact on public perception of the vaccine.

Written by: Richard Dawood, Medical Director and specialist in travel medicine

Book your yellow fever vaccination today.

Links:

Travel Health Advice: Yellow Fever Certificate Required For Nigeria

Read more

Vaccinations for Students

26.08.2019 Category: General Health Author: Dr Richard Dawood

STUDENTS URGED TO GET MENINGITIS ACWY VACCINATION

Public Health England is encouraging students and university freshers to get the Meningitis ACWY vaccination before they start college or university this autumn. Cases of meningitis have risen rapidly since 2009 due to a particularly virulent strain of the Men W & Men B bacteria.

The Men ACWY vaccine is given by a single injection into the upper arm and protects against four different strains of the meningococcal bacteria that cause meningitis and blood poisoning (septicaemia): A, C, W, and Y.

WHAT IS MENINGITIS W?

Meningitis is a bacterial infection of the protective membranes surrounding the brain and spinal cord. Meningococcal meningitis (Men W) is a highly serious form of bacterial meningitis that can lead to septicaemia. It is spread by droplets that come from a person who is infected with the bacteria.

Although the strain is most likely to affect babies, statistics reveal that older children, teenagers, and adults are also at risk. In recent times, cases amongst normally healthy teenagers have spiked and the fatality percentage is higher with Meningitis W than it is with the most common strains, Meningitis B and C.

Early symptoms of Meningitis W include headaches, fever, vomiting, cold feet and hands or muscular pain. All of which could be mistaken for stress or a heavy night out, which is one of the theories as to why students are such high-risk.

Protection against this strain of Meningitis W is provided through the Meningitis ACWY vaccine. Only one dose is required.  We also carry an excellent stock of the Meningitis B vaccine and can provide both vaccinations at the same time should you require it.

Other Vaccines that are recommended for students starting University:

Fresher’s Flu:


  • Every year different flu strains circulate and infect millions of people. Being exposed to a new pool of infections in University accommodation can increase the risk of catching the flu. Having the flu jab before you go to University will help protect you against the flu and stop you getting sick.

MMR:


  • Mumps is a highly contagious viral infection which is spread in the same way as the flu. Coughing, sneezing and kissing can rapidly spread the infection, especially in the close quarters of student accommodation.
  •  Measles is a very infectious viral infection which is also spread by coughing and sneezing. There have been multiple outbreaks of Measles around the world including the UK this year, so it’s important to make sure you are protected as you socialise with new peers.

Both Mumps and Measles can be prevented by safe and effective vaccination, MMR.

BCG:


  • If you are from outside the UK, you should be vaccinated against tuberculosis (TB) before you enter the UK.  A weakened strain of tuberculosis, the BCG Vaccine, is injected to protect against the infection. Those unsure of their immunity can have a simple Mantoux test to confirm.

HPV:


  • HPV is a common virus that is passed on via genital contact. There are more than 100 HPV types which infect genital areas. Sometimes they cause no harm and the infection can go away on its own. However, the virus can persist and cause cells to change which can lead to genital warts or some forms of cancer. The HPV vaccine is offered at our clinic for girls and boys to protect against HPV.

Tetanus:


  • Tetanus is a rare condition caused by bacteria entering a wound. We recommend making sure you are up to date with your DTP vaccinations and boosters before leaving for university. This vaccine protects against tetanus as well as Diptheria and Polio. Don’t let a cut or burn ruin your freshers week.

VACCINATION AT THE FLEET STREET CLINIC

Fleet Street Clinic offers a friendly environment and a team of experienced medics to administer all vaccinations. We meet rigorous quality management standards to ensure we offer you the highest standards of clinical care: you can feel confident you are in safe hands.

Secure your peace of mind by ensuring you are protected.  Get your vaccines before university starts to receive protection in time.

Book your vaccination appointment today

Osteopathy: What's In A Click

19.08.2019 Category: Osteopathy Author: Andrew Doody

Osteopathic manipulation, or HVT (high-velocity thrust) as it is more technically known, is the “click” that many people associate with osteopathic treatment.

It is by no means always used by an osteopath, but when it is, it can prove to be a quick, efficient, and pain-free way of restoring function to a joint.

Many patients’ conditions may not be suitable for HVT, and many may not be keen to have it done anyway. In these cases, the osteopath will treat with a whole collection of other highly effective ways. HVT should be seen as a useful tool in some circumstances, but not a be-all and end-all of osteopathy.

So how does it work?

HVT is placing a short sharp tug though a joint, most often a spinal facet (which is what we will concentrate on here), a click may or may not be heard. The noise itself is a bit of a by-product. What it is has been disputed a little but the generally accepted explanation is that when the joint is stretched, the synovial fluid inside the joint itself physically does not stretch, so gas is forced out of solution causing gas bubbles that allow the joint to gap slightly, causing the clicking noise. This also explains why another click cannot be produced for a little while until the gas has been reabsorbed.
The gapping of the joint is the key to the effectiveness of HVT.

What I must point out at this point though is that the click is not a relocation of a joint.
Barely a day goes past that someone doesn’t tell me their osteopath “clicked something back in” often assuming it was a disc. As much as it can feel miraculous like this sometimes, and a patient can often feel and be quite a bit straighter following treatment, the HVT is about restoring function to the joint, not putting it back in place. Discs especially do not just “pop back in”.

So what does the gapping achieve?

Well, here we have to get a little technical. There are three predominant effects caused by HVT as far as we can tell.

Firstly, post-contractile sensory discharge or PCSD.

Imagine that the brain keeps many muscles at a gentle tension, this allows you to hold your posture. When an area is identified as problematic (painful or inflamed etc), the brain may choose to cause the muscles around the area to spasm, often to protect the area. The spasm itself may cause further pain. This then becomes a vicious circle and dysfunction.

Tension in the muscles is controlled by spindle fibres. This is what detects the short sharp tug of the muscles in HVT. Imagine the short sharp tug as a reset for these fibres. The brain then has to determine the level of muscle tension required and often can reset to the original tension, immediately bringing the joint out of spasm.

Massage of muscles, slow stretching over a longer period, has a similar effect but unfortunately can’t be performed on the small, deep muscles directly around and holding the joint.

Secondly, pain gate theory.

Even when nerves are reporting pain in a certain area, it is important that the body can still detect a soft touch in the same area. To achieve this soft touch and position detecting nerves override deep pain detecting ones. Where you ever told to rub your knee or elbow after you bumped it and it hurt? That’s pain gate, the soft-touch overrides the deep pain. It won’t stop it completely of course but even a little relief will make it feel better. In turn, this may again stop the brain causing the area to spasm.
HVT moves the joint quickly and sharply. This causes the positional detectors to immediately report this to the brain, inhibiting the deep pain.

Thirdly, meniscoid theory.

In a joint, smooth cartilaginous surfaces rub together, but they may not be quite as smooth as we used to think. Small pieces of cartilage appear to be in the joint. Possibly to fill small gaps; craters on a moonscape is a good way to think of it. It has been suggested that when the joint spasms, these small bits of cartilage, which are attached to the capsule around the joint can become trapped out of place. Gapping the joint allows the tethers to the capsule to quickly pull them back into place.

It’s possibly worth pointing out before I finish, that although I said earlier that the click is an unnecessary by-product, I do wonder if it could be argued that the psychological effect of hearing the click could be put forward as a fourth effect. Hearing a click and knowing that it may have relieved a painful joint does often make a patient immediately relax. This may itself be part of the healing process.

Osteopathic manipulation is often a quick efficient way of relieving dysfunction of a joint. It is not a miracle cure. Many other things have to be taken into account for the osteopath to treat fully and effectively.

HVT will not immediately heal damaged tissue or disperse inflammation, but it often is a good way to kick start the process.

Book an osteopathy appointment

By Andrew Doody |  Osteopath | August 2019

Travel Tips Thursday - Tanzania

19.08.2019 Category: Travel Health Author: Anna Chapman

Tanzania is the perfect haven for adventurous travellers. Not only does it boast three of Africa’s Seven Natural Wonders, but it is home to the ancient nomadic stewards, the iconic, Maasai people. It is also the perfect place for an African safari adventure, with it’s 16 national parks accounting for more than 30% of the country.  

Tanzania is blessed with the highest peak in Africa. Mount Kilimanjaro beckons visitors from all over the world. It is the world’s highest free-standing volcano and gets an estimated 30,000 travellers attempting to summit the peak each year. Climbers by the thousands venture here to challenge themselves on its muddy slopes, rocky trails and slippery scree.

It’s crowning jewel is the island, Zanzibar. The island is famous for its mix of exotic white sand beaches, dense palm trees and coral seas. A true paradise. It hosts famous spice plantations and is rich with diverse culture. Unguja (the main island in Zanzibar) is also home to many endangered species including the red colobus monkey and green turtle.

Whether you are visiting for an action-packed safari, challenging yourself to reach the peak of Mt. Kilimanjaro or relaxing on the island of Zanzibar, ensure you follow our top travel tips to stay healthy in Tanzania.

Vaccines

All travellers should ensure they are in date with all their routine immunisations, including diphtheria, tetanus and polio (DTP), and measles, mumps and rubella (MMR). 

You should consider specialist travel vaccinations prior to travel. Hepatitis A and Typhoid are highly recommended. Furthermore, some travellers may also wish to be vaccinated against Rabies, Hepatitis B and Cholera for extra precautions. Especially if travelling to more rural areas.

For more information on our vaccines, please visit our travel and wellness vaccination pages.

Yellow Fever

In Tanzania, there is no risk of yellow fever. If you are only travelling directly from the UK and back, it generally isn’t advised to have yellow fever vaccine. There is, however, a requirement for travellers to have a certificate of vaccination if they enter Tanzania from another country that has Yellow Fever. Bordering countries such as Kenya, Uganda, Rwanda, Burundi & DRC would all require a certificate. In this instance, a vaccination or a waiver certificate may be advised. It is best to speak with a specialist travel nurse, who will look at your route and access what vaccinations and certificates you would require.

Prevent Malaria

Whether you plan to visit Zanzibar or the mainland,  all areas of Tanzania have a risk of malaria. Therefore, you should take anti-malarial medication. Malaria is spread by mosquitoes that are most active between dusk and dawn. A common question is whether or not you need to take them if you plan to trek Mount Kilimanjaro. Even though the risk of malaria is low in areas above 2,500m, the start and finish of the trek take you well below this altitude. In short, you should take medication to prevent it. You should take precautions to reduce the risk of being bitten in the first place.

Precautions include:

  • Wear long, loose clothing
  • Wear plenty of mosquito repellent with a minimum of 50% DEET
  • Use clothes spray containing permethrin – you can spray before you travel for short-duration trips
  • Sleep under a mosquito net

See our Ultimate Bug Kit for everything you need to keep the mosquitos at bay.

Climbing Kilimanjaro

If you are trekking Kilimanjaro, make sure your pre-travel plans take this into account. Trekking is physically demanding and exposes you to the risk of altitude sickness. The summit of the peak is 5,895m and treks can take anything from 5-9 days. Altitude sickness is unpleasant. Not only this but it can develop into something more serious and become life-threatening. Take time to acclimatise. This will reduce your risk of developing altitude sickness. Ideally, choose a longer trek. A slower ascent over more days will reduce your risk considerably. Alternatively, you can get a prescription of acetazolamide (Diamox) to aid the process. Speak to a specialist travel nurse about this at your pre-travel consultation. Don’t let altitude sickness ruin your trip.

Book your travel appointment today

By Anna Chapman |  Travel Nurse | August 2019

Travel Tips Thursday - Bosnia

19.08.2019 Category: Travel Health Author: Anna Chapman

Bosnia is where East meets West.

It is a country on the Balkan Peninsula in southeastern Europe and has become somewhat a destination for adventurous travellers.

Beautiful Ottoman architecture, rugged mountains, captivating castles, raft-able rivers, and humble hiking trails are all reasons why travellers are choosing Bosnia as their next travel destination. The unveiling of the Via Dinarica mega hiking trail means the number of tourists to the Balkan country of Bosnia Hercegovina is expected to rise steeply. The 1930km trail provides a corridor linking traditional cultures between the former Yugoslavian nations. So whether you plan to mill about the city of Mostar, stroll the streets of Sarajevo, or take a hike in the hillside, ensure you follow our top travel tips to stay healthy.

Vaccinations

All travellers are advised to be in date with their routine immunisations, including diphtheria, tetanus and polio (DTP) and measles, mumps and rubella (MMR). Europe has seen huge outbreaks of measles this year alone, so all travellers should make sure they have received at least two doses of the measles-containing vaccination. A simple blood test can be done for all those who are unsure about their immunity. Some travellers may wish to consider vaccinations for Hepatitis A and Hepatitis B, rabies and tick-borne encephalitis. The activities you plan to do whilst travelling will determine which vaccines would be required. If you have any doubts or concerns, we also suggest booking a pre-travel consultation with a specialist travel nurse to discuss your options.

Find out more about our travel and wellness vaccinations.

Trekking and Ticks

Bosnia offers a wealth of outdoor activities. Those who plan to take advantage of the great outdoors should strongly consider vaccination against tick-borne encephalitis (TBE). TBE is a bacterial infection. Usually, it is spread through an infected tick bite. However, during Spring to Autumn, the consumption of unpasteurised dairy produce also carries a risk. Contracting the illness causes a fever with neurological complications.  It is vaccine-preventable. Protection requires  2 doses of the vaccination, given at least 2-weeks apart.  A third dose is given 5-12 months later to give longterm protection. You should also avoid ticks by wearing long trousers and socks. Using DEET insect repellant should also repel them.

If you spot a tick on you, it needs to be removed promptly. Use some flat tweezers or a tick remover and clean the bite with alcohol to reduce the risk of infection.

See our Ultimate Bug Kit.

Rabies

Rabies is a fatal virus that can be found in the saliva of an infected mammal. Most commonly a wild dog. Exposure can happen through a bite, scratch or a lick to an open area of the skin. You cannot catch rabies from another person and it cannot spread through unbroken skin. You should, where possible avoid contact with animals when travelling, especially wild or stay animals.

Rabies is almost always fatal once symptoms appear, but treatment before this is very effective. Pre-travel rabies vaccination offers great protection. And means that in the unlikely event you come into contact with the rabies virus, fast and effective treatment can be given easily and in the country of the incident.

Pre-travel rabies protection requires a series of 3 vaccinations given as injections into your upper arm. Your vaccines will be given over a 3-week period, or over 1 week if an accelerated course is needed, prior to travel. Travellers at greater risk are those who plan to do outdoor activities such as hiking, trekking, cycling or caving. You should consider a rabies vaccine if you plan to do any of these activities whilst visiting Bosnia.

First Aid Kit

For those trekking in the hills, packing good basic first aid kit is essential. When travelling in rural areas, access to healthcare can be limited. Travelling with a medical kit will give you access to basic provisions needed to treat minor injuries and pains.

Basic provisions include pain relief, plasters and medication to treat an upset stomach, such as loperamide and oral rehydration salts. If access to safe water may be limited, consider packing chlorine dioxide tablets. Cuts, scapes blisters and even a twisted ankle can occur, so take blister pads, some waterproof dressings and a bandage to deal with any minor injuries whilst you are there. If you take regular prescription medication, ensure you pack enough for the duration of your trip and carry the prescription with you.

Book your travel appointment today

By Anna Chapman |  Travel Nurse | August 2019

Fleet Street Clinic Bug of the Week: Cyclospora

19.08.2019 Category: Travel Health Author: Anna Chapman

What is Cyclospora?

Cyclospora is a tiny, single-celled parasite, spread by contaminated food. It can cause diarrhoea, abdominal cramps, nausea, loss of appetite, bloating, gas, fatigue, mild fever, and weight loss.

 Why is it in the news?

There’s been an outbreak in travellers to Mexico, with at least 204 reported cases in returning holidaymakers since June. However, it is difficult to detect using standard tests. Because it is uncommon in the UK, most labs don’t look for it and may miss the diagnosis. So the true number is probably much higher.

 What’s the most reliable way of detecting it?

The best way is called a rapid PCR test, which detects the parasite’s DNA. The test also looks for DNA and genetic material from 21 other diarrhoea-causing parasites, bacteria and viruses at the same time – so there is a very high probability of finding the right cause. As you’d expect, the test is available at the Fleet Street Clinic. Importantly, we can have a result within an hour or so of receiving a sample.

How can I prevent it?

Outbreaks have been linked to eating fresh uncooked berries/unpeeled fruit and salad items that have not been washed in safe water. Sticking to foods that have been freshly and thoroughly cooked, when you travel, is the safest option.

 How is it treated?

Confirmed cases can be treated with an antibiotic called co-trimoxazole. Some of the more commonly-used antibiotics for travellers’ diarrhoea may not be effective.

If you have any concerns about cyclospora and other parasites, our PCR test service can help detect the exact cause of any issue you might have. What this allows is proper diagnosis and treatment. Usually,  guess-work on what bug a patient is carrying or general prescriptions to tackle the illness might be given by medical professionals. The PCR test offers accuracy like nothing else.

You can book an appointment online.