Hajj and Umrah are religious pilgrimages to Mecca, Saudi Arabia. Hajj is a mandatory Pilgrimage for every Muslim to take once in their lifetime, given that the individual is physically and financially able.

It takes place in the last month of the Islamic calendar and is taken annually by 2.5 million Muslims worldwide pre-pandemic. Whereas, Umrah is a shorter pilgrimage to Mecca taken any time of the year. 

Muslims from all over the world gather annually in Mecca in a display of unity, faith and solidarity. Due to the large number of participants performing the pilgrimage there are some health risks you should be aware of.

There are also health requirements set by the Health Ministry of Saudi Arabia that you could affect your VISA. It is good to be aware of those requirements before travelling. 

COVID-19 Requirements:

Ministry of Health KSA states that in order to perform Hajj pilgrims, one must have the proof for the following: 

• A full course of COVID-19 vaccinations (second dose of a two dose vaccine or received a single dose vaccine) approved by the Saudi Ministry of Health. The approved vaccines’ list can be found here – Ministry of Health Approved Vaccines. 
• There is no longer a requirement for PCR testing to perform Hajj or to enter KSA. 

Vaccine Requirements:

A pre-travel consultation should be scheduled at least 4 weeks before your trip.
Any mandatory or advised vaccinations will be discussed with a nurse and can be given in the appointment. Follow up doses can also be arranged in the appointment.

Before travelling to Hajj or Umrah, it is recommended that pilgrims be up-to-date with all of their wellness vaccinations.

– Meningitis

All British citizens travellers performing Umrah or Hajj are required to submit a valid Meningitis ACWY vaccination certificate in order to obtain a visa.  The MenACWY vaccine protects against meningitis (strains A, C, W & Y) and sepsis. Adults and children over the age of 2 are required to have the vaccine and provide evidence of immunisation no less than 10 days before you plan to arrive in Saudi Arabia. This requirement also applies to seasonal workers in Hajj areas.
You may also want to consider Meningitis B vaccine – this is not a mandatory VISA requirement.

If you require a vaccination, you can choose from our available appointments online – click to book your appointment.

– Covid-19

All travellers must be vaccinated against Covid-19 to perform Hajj Pilgrim. The vaccines that are approved by the Ministry of Health KSA can be found here – Ministry of Health Approved Vaccines.  

– Polio

Travellers from countries reporting positive environmental sources samples of circulating vaccine derived polio virus 2 (cVDPV2), including the UK, are recommended to be vaccinated with at least one dose of IPV within the previous 12 months and at least four weeks prior to arrival, however there is no polio vaccination certificate requirement. 

A polio certificate requirement will only apply to UK pilgrims if they are travelling to KSA via a country reporting WPV1, cVDPV1 or cases of cVDPV2 or Acute Flaccid Paralysis, and not if they are travelling directly to KSA from the UK. 

If you require a vaccination, you can choose from our available appointments online – click to book your appointment. 

– Flu Vaccine

Since both Hajj and Umrah both pose crowded conditions and close contact, seasonal flu vaccination is advised, especially for those who are more vulnerable to severe influenza diseases. This precautionary measure will help reduce the potential spread of the flu.

If you require a vaccination, you can choose from our available appointments online – click to book your appointment.

– Hepatitis B

Hep B is spread by contaminated blood and bodily fluid. Pilgrims who intend to shave their heads as one of the rites of Hajj should consider taking the vaccination. Although licensed barbers performing head shaving are obliged to use a new blade for each pilgrim, unlicensed barbers may not adhere to this practice. Vaccinations require 3 injections to be given over a 3 week period and can be given from birth. 

If you require a vaccination, you can choose from our available appointments online – click to book your appointment.

– Rabies

Rabies is  spread through the bite of an infected animal such as cats, dogs, monkeys and bats. Saudi Arabia is classified as a high-risk country for rabies. Full protection is achieved with 3 doses – 3 vaccinations usually given over a 3 week period, however, we do offer a rapid course which can achieve full protection in 7-days.  The rabies vaccine can be given from birth.

If you require a vaccination, you can choose from our available appointments online – click to book your appointment.

TRAVELLERS’ DIARRHOEA

Travellers’ diarrhoea can occur in up to 60% of travellers. Although most cases are mild, taking sensible precautions with food and water can reduce the risk. Carrying medicines for self-treatments is useful such as antibiotics – take our Online Travellers’ Diarrhoea Consultation to see if it is suitable for us to prescribe you standby Travellers’ Diarrhoea treatment.

The best protection are preventative measures such as  drinking bottled or purified water, washing your hands thoroughly and frequently and eating well-cooked, hot food.

Fore more information on Travellers’ Diarrhoea.

CLIMATE HEALTH

Saudi Arabia has had some of the hottest temperatures on record this year. Exposure to such high temperatures increases sweating, and results in loss of fluid and electrolytes which can cause rapid dehydration. This can result in heat exhaustion or heat stroke which can be life threatening if not dealt with promptly. 

Heat related illness can be avoided by the following:

• Seek shelter and shade during the middle of the day (11am-3pm) when temperatures are the hottest
• If you are outside, ensure you protect your skin against the sun with high factor sun cream
• Wear loose fitting, lightweight and light colour clothing 
• Keep hydrated by drinking plenty of fluids
• Ensure you are taking sufficient salt in your diet (sweating leads to electrolyte and salt depletion)
• Avoid caffeine and alcohol, which can worsen heat related illnesses

GENERAL HEALTH:

Both Hajj and Umrah pilgrimages require strenuous effort, it is worth considering having a full body medical check up before you travel to ensure you are in good health. To prepare for the miles of walking, try increasing your physical activities to improve mobility and movement. In case of unforeseen circumstances, remember to pack a first aid kit and extra supplies of any prescribed medication you are currently taking. We have an onsite pharmacy if you’d like to purchase any of these items during your appointment, speak with your GP or nurse whilst at the clinic.

DENGUE AND MALARIA:

Dengue is spread by day-biting mosquitoes and Malaria by mosquitoes that are active at night. You can reduce your risk of insect bites by using effective insect repellents and protective clothing. You can also sleep under a mosquito net that is impregnated with insecticide to have a peaceful sleep. 

If you require complete protection from bugs and mosquitoes, you can check out our ultimate bug kit here.

Delaying your period:

If you decide you would like to delay your period for pilgrimage, you can do so by taking hormonal medication. In advance of your trip, book an appointment with a GP to discuss your options as soon as possible.

When you get home:

If you return home unwell it is important to book an appointment with a GP to determine the cause. If your symptoms worsen or becoming life-threatening do not wait to see a doctor, go straight to A&E for urgent medical care.

If you return with a stomach bug or persistent travellers’ diarrhoea, you may want to consider booking a Gastrointestinal (GI) Panel PCR test – it looks for any microbes (bacteria, viruses & parasites) that may be causing your symptoms and can quickly identify the exact cause. Results can be provided in as little as 1-hour, so that accurate and effective treatment can begin straight away. Firstly, you need to book a GP appointment, express your interest in a GI PCR test and they will advise whether you are suitable or not.

Dengue Fever has been in the news following two cases linked to travel to the Spanish island of Ibiza. This has sparked concerns about the spread of mosquito-borne illnesses in Europe, which is especially unusual for this time of year.

Dengue fever is a viral infection transmitted by the Aedes mosquito, which is found in tropical and subtropical regions worldwide. With rising temperatures and changing climates, there is a risk of mosquitoes and other disease vectors spreading to new areas, potentially causing outbreaks of diseases such as dengue fever.

The two cases of dengue fever in Ibiza were reported by the Spanish Ministry of Health and were both in residents of Germany who had visited the island before becoming ill. Each case was accompanied by two family members who were also suspected to have had dengue fever.

The risk of dengue fever in Spain is highest between the months of May and November, when mosquitoes are most active so to have cases at this time of year is uncommon.

So, why are we seeing cases outside of the usual infection months?
The reason is multi-facetted.

Our medical director and travel health specialist, Dr Richard Dawood explains:

“Firstly, there is the introduction or spread of mosquitoes to “pastures new” – places that might have been previously inhospitable, perhaps through temperature; or alternatively, that offer an environment with plenty of suitable breeding sites that they are suddenly able to take advantage of. These mosquitoes can bring disease with them, or can spread it around if there is a reservoir in the local population.

Secondly, there is the possibility of introducing disease to a vector population that is already established, ready and waiting. This is exactly the (long-standing) concern with yellow fever. There are mosquito species in Asia, for example, that are easily capable of spreading yellow fever were it to be introduced by an infected traveller – which is why Asian countries are so careful to insist on proof of yellow fever vaccination from travellers arriving from the endemic zones of Africa and South America. Asia is yellow fever-free, and wants to remain so. However, this type of introduction has already recently happened in Australia, where Japanese encephalitis (a virus infection that can cause rare but serious complications in humans) has recently established a reservoir of infection in farm animals, that may be impossible to reverse. It is also happening with Lyme disease spreading gradually into parts of Europe (and the UK) with a susceptible tick population.

Similar concerns apply to Zika – there is very large potentially susceptible mosquito population that could spread the virus in many tropical countries, if introduced; dengue fever; and also potentially malaria, in parts of the world that have been the target of successful elimination campaigns, but where mosquito populations could still spread it, were it to be reintroduced, if control measures are neglected or ceased.

With changing climates, a valid concern about global warming is that it could create conditions in which populations of mosquitoes and other vectors thrive and spread – hence the crucial importance of vigilance, surveillance, and early action if needed.”

How can you protect yourself from Dengue Fever?

There is no vaccine against dengue licensed in the UK, though several candidate vaccines are in development.

The best way to protect yourself against dengue fever is to take measures to avoid mosquito bites. This includes wearing protective clothing, using mosquito repellent, and staying in places with air conditioning or screens on windows and doors.

If you develop a high fever during or after travelling to an affected area, seek medical advice as soon as possible and provide details of your recent travel history. Dengue is often also accompanied by a rash and joint or muscle pain.

In conclusion, rising temperatures and changing climates have the potential to create conditions in which populations of mosquitoes and other disease vectors thrive and spread. It is crucial for public health authorities to remain vigilant and take early action if needed to prevent the spread of diseases such as dengue fever. By taking appropriate measures to protect against mosquito bites, travellers can reduce their own individual risk of contracting dengue as well as other insect-borne infections.

Suitable Medical Kits available to buy online

Buy: Ultimate Bug Kit

Buy: Essential First Aid Kit

Related services available at Fleet Street Clinic

Travel Vaccinations

Travellers’ Diarrhoea Online Consultation

Antimalarials

HIV (Human Immunodeficiency Virus) is a viral infection that damages cells in your immune system. As a result, it weakens the body’s ability to fight off everyday infections such as the common cold. If you have HIV and get sick with a cold, you are much more likely to experience complications, such as developing pneumonia.

HIV is found in the body fluids of an infected person, such as semen, vaginal and anal fluids, blood and breast milk. It is not found in sweat, urine or saliva. Meaning HIV is typically spread by unprotected sex, the sharing of injecting equipment such as needles, and/ or passed from mother to baby either through birth or breastfeeding.

About National HIV Testing Week

National HIV Testing Week #HIVTestWeek aims to raise awareness of HIV and AIDS. It is an annual national campaign to encourage people to get tested for HIV regularly to reduce the number of people who are diagnosed late or remain undiagnosed.

Out of the 106,890 people in the UK with HIV, 1 in 20 of those do not realise they are HIV positive. Which is why it is so important to make sure everyone gets tested to know their status.

Data from 2019, revealed that  42% of people were diagnosed late. A late diagnosis significantly increases the risk of the virus seriously damaging your health, not to mention the fact that you are more likely to pass the virus on during the period when you are unaware of a positive diagnosis. The only means to address this issue is to increase awareness of the importance of HIV testing.

If you have HIV for a long time without knowing, it can damage your health and shorten your life expectancy. It’s a good idea to test at least once a year (or more if you have unprotected sex with more than one partner). Early detection can give you a better quality of life and reduce the spread of the disease.

While there is no ‘cure’ for HIV, thankfully there are now very effective treatments available that allow those who are HIV positive to live a healthy life and have a normal life expectancy. There is also emergency treatment available if you have been exposed to HIV within the last 72 hours (PEP). Additionally, there is medication available to prevent contracting HIV (PrEP) and even a tablet that will prevent you passing the virus on to anyone else. Access to these treatments is available to anyone HIV positive but the only way to know your HIV status is to get tested. 

Know Your Status

At Fleet Street Clinic, we have two types of HIV tests available: an instant test and a blood test. An instant HIV test can provide you with results within a 15 minute nurse appointment. The test is a simple blood test done via a needle prick to the finger and is suitable for use 90 days post-exposure. It is a very simple process with extremely accurate results.

For HIV testing week we’re promoting our ‘So quick you can do whilst grabbing a coffee’ campaign to highlight just how quick an HIV test can be. We want to encourage all to make time to find out their HIV status.

Get Tested

We offer a number of HIV Tests, some of which can be performed in the clinic in just 15 minutes. You can be tested for HIV from as early as 28 days post-contact with a blood test, but don’t worry, during your appointment the clinician will let you know which test they recommend based on your history. Following an HIV test, we are on hand to offer guidance and referrals, should they be required.

Your privacy will be strictly protected.

You can book an HIV Test Online.

For more information on HIV you can visit our HIV page or  HIV Prevention England.

Statins are a widely prescribed class of drugs used to lower cholesterol levels and prevent cardiovascular events such as heart disease and strokes. The National Institute for Health and Care Excellence (NICE) has recently released updated guidelines on the use of statins, which now recommend that they can be considered for people at a lower risk threshold.  

This decision was made after the independent committee updating the NICE guideline on cardiovascular disease (CVD) risk assessment and reduction considered new evidence on the safety and side effects of statins, meaning more people could be given them. 

The draft guideline recommends that doctors should consider statins for people who haven’t had a CVD event (called ‘primary prevention’) with a 10-year CVD risk score of less than 10%. The committee agreed that if more people took statins there would be a greater reduction in the incidence of heart disease and strokes. 

In addition to being prescribed by National Health Service GP’s, statins can also be prescribed by private healthcare providers, such as us, Fleet Street Clinic. In fact, private GP’s can play an important role in the management of cardiovascular disease risk by offering statins as part of a comprehensive treatment plan for patients at high risk. 

People can be at risk from CVD because of factors they cannot change including their age, sex, ethnicity and family history but it’s important to note that certain lifestyle changes can reduce the risk. These include stopping smoking, reducing alcohol consumption, introducing or increasing exercise and eating a healthy diet.  

Therefore, the decision to take a statin should be made in consultation with a healthcare professional and should take into account the individual’s values and priorities as well as the potential risks and benefits of treatment. 

With the British Heart Foundation noting that “there are around 7.6 million people living with heart and circulatory diseases in the UK” and that they “estimate that in the UK more than half of us will get a heart or circulatory condition in our lifetime” this is likely to be an impactful change in the landscape of CVD and statins. 

To conclude, Paul Chrisp, director of the Centre for Guidelines at NICE, said:  

“What we’re saying is that, for people with a less than 10% risk over 10 years of a first heart attack or stroke, the decision to take a statin should be left to individual patients after an informed discussion of benefits and risks.  

“The evidence is clear, in our view, that for people with a risk of 10% or less over 10 years, statins are an appropriate choice to reduce that risk.  

“We are not advocating that statins are used alone. The draft guideline continues to say that it is only if lifestyle changes on their own are not sufficient, and that other risk factors such as hypertension are also managed, that people who are still at risk can be offered the opportunity to use a statin, if they want to. They don’t have to, and their decision should be informed by an understanding of the risks and tailored to their values and priorities.” 

Reference Source: https://www.nice.org.uk/guidance/indevelopment/gid-ng10178/documents 

Related services available at Fleet Street Clinic:

• GP appointment
• Instant HbA1C testing

Sleep plays a crucial role in maintaining overall health and well-being, and recent research has revealed a strong link between sleep and cardiovascular health. A study conducted by the University of Warwick in the UK found that individuals who get 7-9 hours of sleep per night have a lower risk of cardiovascular disease (CVD) and mortality compared to those who sleep less or more than the recommended range. 

The study, published in the Journal of the American College of Cardiology, analysed data from over 116,000 participants in the UK Biobank study and found that those who slept less than 6 hours or more than 9 hours had a higher risk of CVD and mortality. These findings add to the growing body of evidence that suggests a link between sleep duration and cardiovascular health. 

The exact mechanisms by which sleep affects cardiovascular health are not fully understood, but researchers suggest that it may be related to the impact of sleep on cardiovascular regulation, inflammation, and metabolic function. 

It is important to prioritize sleep and aim for the recommended range of 7-9 hours to maintain cardiovascular health.  

It’s worth noting that these findings are observational, and more research is needed to fully understand the relationship between sleep and cardiovascular health, but it’s a good indication that sleep plays a vital role in maintaining a healthy cardiovascular system. 

To read the full study, continue reading here:
medscape.co.uk – Does sleep duration influence cvd and mortality risk?

Related services available at Fleet Street Clinic: 

• GP Services
• Well Person Medical

Travelling can have a significant positive impact on one’s physical and mental health, according to a study published in the Journal of Travel & Health. The study surveyed over 1,000 adults who had recently returned from a trip and found that the majority of them reported improvements in overall well-being, including increased energy and reduced stress levels. 

One of the key reasons for these self-rated health benefits is that travelling allows individuals to step out of their daily routine and experience new environments and cultures. This can lead to increased physical activity, as travellers may be more likely to walk or bike instead of drive which may also expose them to different types of food, leading to a healthier diet. 

Additionally, travelling can have a positive impact on mental health as well. The study found that the majority of participants reported feeling more relaxed and less stressed after their trip. This is likely because travelling can provide a sense of excitement and adventure, as well as a break from the demands and responsibilities of everyday life. 

Another benefit of travelling is that it allows individuals to build new social connections, which can be important for mental health. Meeting new people and forming new friendships can provide a sense of belonging and can also help to reduce feelings of loneliness and isolation. 

In conclusion, the study suggests that travelling can be good for one’s physical and mental health. It can help to increase energy levels, reduce stress and improve overall well-being. So, next time you are planning a trip, remember it’s not only good for your soul but also for your body. 

To read the full study, continue reading here: https://www.sciencedirect.com/science/article/pii/S2214140522002079?via%3Dihub 

Related services available at Fleet Street Clinic: 

• Travel Vaccinations
• Jet Lag Calculator
• Travellers’ Diarrhoea Online Consultation
• Antimalarials
• DVT Rick Calculator

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 perhaps because we so familiar with the term “January Blues” but Blue Monday is in fact, a myth! 

The phrase “Blue Monday” was coined by Sky Travel back in 2005 as a way to encourage people to book their next holiday as something to look forward too. 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. It did, however, get use thinking about our mood, mental health and overall wellbeing at this time of year.

January is cold, often wet and everyone is trying to shake off the Christmas comedown and get excited about the new year ahead, but the January blues can creep in.

Remember you are not alone, and many people experience a dip in mood this time of year but it is important to identify when the January blues are actually symptoms of depression.

Depression is more than simply feeling unhappy, fed up or low 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.
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.

Click to book a GP appointment

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 2023 being the Year of the Rabbit. Celebrations for Chinese New Year kick off on the 22nd Jan, continuing until the  5th 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. If you travel to China after 8th Jan, you would require a negative Covid-19 test and submit your negative result by filling a Health Declaration Form via China Custom Website or their app or WeChat account. You would also need a pre-departure Covid -19 test when coming back to England from China. If you are 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, Typhoid, 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 2022-23, 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 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.

Dry January grows in popularity year on year.

The campaign by Alcohol Change UK, encourages participants to give up alcohol for the entire month of January.

The dry January one-month booze-free challenge can have a significantly positive impact on your health.

Alcohol has proven to increase the risk of developing a range of health problems (including cancers of the mouth, throat and breast) and that risk increases the more you drink on a regular basis.

Ruth Kander, our dietitian, looks at what is considered a safe amount of alcohol consumption.

The UK Chief Medical Officers’ (CMOs) guideline for keeping health risks from alcohol to a low level for both men and women states that:

• It is safest not to drink more than 14 units a week on a regular basis.
• Regularly drinking as much as 14 units per week, it’s best to spread your drinking evenly over three or more days. 
       – If you have one or two heavy drinking episodes a week, you increase your risk of death from long-term illness and injuries.
• Cutting down the amount you drink, a smart way to help achieve this is to have several drink-free days a week.

A useful website for more information about alcohol is www.drinkaware.co.uk

What is a unit of alcohol?

How long does alcohol stay in your body?

On average, it takes about one hour for your body to break down one unit of alcohol, however, this can vary, depending on:

• Your weight
• Whether you’re male or female
• Your age
• Your metabolism – how quickly or slowly your body turns food into energy
• How much food you have eaten
• The type and strength of the alcohol you have consumed
• Whether you’re taking medication and, if so, what type
• It can also take longer if your liver isn’t functioning normally

If I am on medicines can I drink alcohol?

People taking sedative drugs (like diazepam/valium) or antidepressants (like fluoxetine/Prozac) should avoid alcohol altogether.

There are some antibiotics; metronidazole and tinidazole which just do not mix with alcohol – drinking with these will make you sick. But for most commonly prescribed antibiotics, drinking is unlikely to cause problems so long as it is within the low-risk alcohol unit guidelines.

People taking long-term medications should be careful about drinking, as alcohol can make some drugs less effective and long-term conditions could get worse. Examples of long-term medications include drugs for epilepsy, diabetes, or drugs like warfarin to thin the blood.

(From www.drinkaware.co.uk)

What are the consequences of drinking too much alcohol?

• Low mood/mood swings
• Liver problems
• Heart problems
• Cancers (mouth, tongue, throat, oesophagus)
• Weight gain
• Poor sleep
• Blood pressure instability

By Ruth Kander BSc(Hons)RD | Dietitian

If you wish to discuss ways to maintain a healthy diet and reduce your alcohol consumption, Ruth holds a virtual clinic every Friday from 9am-2pm. 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

Fleet Street Clinic will remain open for limited services most of the Christmas period.

We shall be fully closed on 25th December, Christmas Day and 1st January, New Year’s Day. 

Our services during this time will be limited to nurse care, covid PCR testing, GP services & travel appointments. All appointments are to be booked in advance and by appointment-only. Please continue to use our online booking system during this time to make your appointments.

Christmas Opening Hours 2022:

Christmas Eve – 9am – 1pm
Christmas Day – Closed
Boxing Day – 9am – 2pm
Tuesday 27th – Wednesday 28th Dec – 9am – 5pm
Thursday 29th Dec – 9am – 1pm
Friday 30th Dec – 9am – 5pm
New Year’s Eve – 9am – 1pm
New Year’s Day – Closed
Monday 2nd Jan – 9am – 5pm

Normal opening hours with full services resume from 3rd January 2023.

Please Remember:

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.

Book An Appointment Online

Merry Christmas and a Happy New Year from all at Fleet Street Clinic.
We look forward to serving you in the New Year.

Flu cases in the UK have increased earlier this winter than usual, perhaps by over a month.

Other unpleasant respiratory infections such as RSV are also on the rise.

Information from around the world can help us predict what might type of flu season might be heading our way.

• Australia has just come to the end of a bad flu season, with a dramatic increase in flu cases and hospitalisations relative to the mild season it experienced last year, in a pattern likely to be replicated in the UK.
• In the USA, by the end of November 2022 there had already been more than 6.2 million flu cases, with 53,000 hospitalisations, and 2,900 deaths from flu.
• Across Europe as a whole, the flu season has commenced earlier than in the 4 previous seasons, and the proportion of positive tests from sentinel locations has exceeded the technical threshold for consideration as an epidemic.

Meanwhile, UK vaccination rates have so far been low: by the end of November, when the flu vaccination campaign should be largely complete, fewer than 40% of “at risk” adults under 65 had been vaccinated, fewer than 25% of healthy adults aged 50 to 64, and fewer than 30% of pregnant women.

So this winter’s flu season is likely to be more severe, and not enough people will be protected.

What can you do to keep well this winter?
Get Vaccinated . Get Tested . Get Treatment

Get Vaccinated

The good news is that circulating flu strains have so far been a good match with this year’s flu vaccines. It is not too late to be vaccinated. Vaccines are still available. At this point in the season, our preferred vaccine for adults is our premium recombinant vaccine, Supemtek, which is known to be highly immunogenic.

Flu cases in children are rising but the nasal spray vaccine has so far been in restricted supply. If your child has not yet been able to obtain the flu spray, injected flu vaccines are at least as effective and should be given without further delay.

You can easily book your flu jabs online.
For family or groups bookings, it may be more convenient for you to book by phone or email.

Get Tested

At the Fleet Street Clinic, we can test quickly and accurately for a full panel of respiratory viruses in our own laboratory. It is helpful to know whether you are suffering from flu, covid, or another circulating virus such as RSV or metapneumovirus. We can tailor treatment to the result, help you know how long symptoms will last, and can help you prevent spreading it to others – especially important over the Christmas period when socialising in high at work and amongst family and friends.

Get Treatment

Flu is treatable with anti-viral drugs, which reduce symptoms and speed recovery. Preventive treatment for close contacts and other members of your family is also something we can help with, available from our GPs. Knowing for certain that you have a viral infection can also help avoid unnecessary antibiotic treatment.

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For more information on Flu Jabs available at Fleet Street Clinic.
Other recommended winter vaccinations are the shingles vaccine & the pneumonia vaccine.

We can also provide onsite Workplace Flu Vaccinations for companies in the UK – for more information.

The Chevron, the Dali or the Handlebar – what moustache will you choose to grow this Movember?
Movember is the time of year when men across the globe ditch their razors to ‘Grow a Mo’.

‘Movember’ is the leading global men’s health charity raising money to find research in 3 main areas; prostate cancer, testicular cancer and mental health and suicide prevention. Movember aims to open up conversations and remove the stereotype of a ‘strong, silent man’ so they can stop men from dying too young.

Since being launched, Movember has raised over $837 million for men’s health issues – much of which has been invested in research centres around the country as well as worldwide. Movember have funded more than 1,200 men’s health projects all around the world. This would not be possible if they did not receive continued support from all those that donate every day.

The goal of Movember is to “change the face of men’s health” – quite literally every November!
The foundation is taking action on three key health issues faced by men, prostate cancer, testicular cancer and mental health and suicide.

Prostate Cancer-

In the UK, one man dies of prostate cancer every 45 minutes. That is a shocking statistic!
Thanks to research and funding more men are being diagnosed earlier and living longer, however, this does not mean that we should stop raising vital funds for more research. Our clinic offers a comprehensive Prostate Cancer check with an experienced doctor, who will address your concerns, explain the testing process, discuss the results with you, and arrange any follow-up that may be necessary. The Prostate cancer check will include a detailed health discussion including lifestyle and family history, internal (rectal) examination of the prostate gland and a prostate-specific antigen (PSA) blood test.

Testicular Cancer –  

Testicular Cancer is the most common cancer among young men in the UK and often can strike quickly.
Knowing the symptoms can help with earlier detection which will help save lives. Testicular cancer starts as an abnormal growth or a tumour that develops in one or both testicles. A lump or swelling of the testicle, a heavy scrotum and discomfort or pain in the testicle or scrotum are some of the more common symptoms which all men should be aware of.

Mental Health –

Part of the stigma, that still exists about mental health for men is that men have greater difficulty talking about their struggles than women do.
The Movember Foundation has funded programmes all around the world to help support men’s resilience and mental well-being, encouraging them to talk about their problems and prevent suicide. Moustache season is about men growing real moustaches and being encouraged to talk about mental health.

Important men’s health tests at Fleet Street Clinic –

A Well Person Medical (From £299) – 

Standard – A standard well person medical is a 1-hour appointment with one of our experienced GPs. During your appointment, our GP will review your medical history, any medications you are on and conduct a physical examination. This is supported by a number of tests to review your current health including a urine analysis and blood test to check for infection markers, glucose, protein and cholesterol levels, and your liver and kidney function. For Men, our GPs will also carry out a prostate examination. 

Executive – An executive well person medical is a 1.5 hours appointment with one of our experienced GPs. You benefit from all the services included within our standard well person medical, as well as a few extras like  a bowel cancer screening test (faecal immunochemical test – a FIT test) and an audiometry (hearing test). For Men, our GP will also carry out a physical prostate examination and a prostate PSA blood test.

Prostate Cancer Check (£175) –

Prostate cancer is the most commonly diagnosed cancer in men in the UK. Early diagnosis often leads to a better outcome and so regular screening is essential to alleviate unnecessary worry and to catch the cancer early.

A prostate cancer check is carried out by one of our experienced male GPs. It consists of a detailed health discussion about your current health, your prostate cancer risk including lifestyle risk factors and family medical history. An internal (rectal) examination of the prostate gland is done alongside a prostate specific antigen (PSA) blood test. 

The blood sample for your PSA blood test is sent by courier to our nearby pathology laboratory. Our GP will let you know when to expect your results and when they will discuss that with you, along with any follow-up required. 

Book your Appointment Here

A good night’s sleep is essential to your health, and an important part of your overall well-being. People spend about a third of their lives in bed, so it’s vitally important to get it right when it comes to back health. Back pain can significantly affect a person’s ability to get the quality and amount of sleep they need. Furthermore, poor bed posture can worsen or even be the cause of backache in the first place. This is because certain positions can place unnecessary pressure on the neck, hips, and back.

This blog will provide an in-depth review of different sleeping positions and types of beds and the impact both have on your quality of sleep.

Sleeping positions

Before looking at the positions to sleep better, it is important to address a few crucial things. First and foremost, you should be comfortable. For a good night’s sleep, waking up feeling properly rested and not in pain is the most important thing. If any of these positions cause issues, don’t hesitate in letting me (or another osteopath) know so that alternative suggestions can be made and you find something else that works for you.

Secondly, I know it’s not always possible to control what position you get into once you’ve fallen asleep. However, this is where perseverance comes in, if you keep trying, your body can adapt in a week or two. Pillows are always a good ally, to stop you rolling one way or the other.

Here are some positional tips that can help you get a better night’s sleep:

1. The Classic: Lying on your back.

Lying on the back is probably the best all-around sleeping position for a healthy back. It ensures good spinal alignment from the head and cervical vertebrae, through the thoracic and lumbar, all the way down to the pelvis. Because the back is the body’s largest area, weight is most widely distributed in this position, minimising pressure hot spots. This doesn’t suit everyone though, some people don’t feel as ‘nested’ as in other positions so, they struggle to get to sleep on their backs. Also, snorers may find that this position exacerbates the problem.

For people who like back sleeping, it’s definitely worth adding a pillow under your knees. It loosens the hamstrings a little and takes some pressure off the lumbar lordosis.

2. The Foetal Position: Lying on your side with your knees up a little.

This is a fairly intuitive position to get into if you have lumbar disc issues as it slightly flexes the low back and opens up the gaps in the facet joints.

Again, a good tip in this position is to use a pillow, however, this time put it in between your knees. This stops your top leg dropping forward and rotating the low back. It also aligns your hips and pelvis better, and feels more comfortable on the upper knee.

Try to swap sides from time to time if you’re lying in the foetal position.

3. Face Down: Lying on your stomach. 

I normally ask people to avoid this position, it’s usually quite problematic for the neck as well as the low back. Unfortunately, for a lot of people, it’s the only position they can fall asleep in, or any other position makes them snore. If you’re one of them, reach for that extra pillow again and put it under your low stomach and upper pelvis to take the pressure off the low back. This is a good idea if you’re having a massage too. Front lying needs a much flatter pillow (or even no pillow) under the head too.

If you’re someone who falls asleep on their back or side, then rolls over in their sleep and wakes up on their stomach, try hugging a large pillow against your chest and stomach to keep you in position. Another reason sleeping on the front is considered bad is because the head is usually turned to one side. This twists the spine and places additional stress on the neck, shoulders, and back. To avoid this, you can try lying face down. Place a small firm pillow or tightly rolled-up towel under the forehead, or better still a face pillow, allowing room to breathe. In this position, you should still place a pillow under the stomach.

4. Reclined Sleeping.

If all else fails, you can try sleeping in a reclined position. People with spondylolisthesis, for instance, may resort to this after finding it comfortable falling asleep in a recliner chair. There are beds available that can be sat up slightly. So, this is worth investigating.

What about the perfect bed for sleep?

There are so many different opinions about beds that I don’t even know where to start, nonetheless here’s mine.

Spend some time and effort (and dare I say money) choosing a bed and mattress. People seem happy to spend thirty times or more on a car than a mattress, but remember, a third of your life is spent in bed! 

It’s really difficult to choose a mattress on a twenty minute trip to the bed store, so really take your time, spend an afternoon there, take your shoes off, try different sleeping positions, not just lying on your back! Do your research before you go, but make sure the review sites you look at aren’t secretly run by a bed company, or affiliated to one.

Firmness

Try not to be seduced by softness. Lots of people jot down the name of a mattress they’ve found comfortable in a hotel, and while this can sometimes be a good indicator, you should know that hotels buy mattresses to give you a couple of nights feeling like you were sleeping on a cloud, but these mattresses are usually not supportive enough to be using full time, especially if you have low back issues, which can be aggravated over weeks and months. Often the mattress in a big hotel chain is not available to buy for the public as they are specifically manufactured for different hotels’ standards.

A fairly firm mattress is usually a good idea, perhaps with a shallow in-built topper. This can give you the support you need for your low back while the topper takes the pressure off bony prominences and allows shoulders and hips of side sleepers to sink in a little. I suggested a built in topper as they are usually better segmented and don’t allow stuffing to move around and bunch up as much. However, removable toppers give you more scope to adapt by removing it if needed, and also allow you to flip the mattress.

Mattresses that are fully stuffed as well as sprung are good and supportive. Price is a good indicator for a quality mattress. £1,500 for a king size mattress is not excessive. While we’re talking about price, beware of anything that seems too good to be true. The “Winning awards” mattresses need to be checked as to which award, and who’s giving it!

Memory Foam Mattress

Patients have different opinions about memory foam mattresses. While some patients swear by them, others do not get along with them. I’d like to reiterate the price, if you’re set on a memory foam mattress, find the one with better quality, so it doesn’t start to develop a permanent dip where you lie. It’s all about density which is measured in pounds of pressure per cubic square foot. More is normally more expensive and better quality, but at the same time is also more supportive and feels harder. 

There can be a problem with memory foam mattresses feeling too hot. While many of the better brands have addressed this to an extent, many memory foam mattresses have become hybrids so, it’s not just 100% foam any more.

Platform Bases

Mattresses should be changed about every 8 years, but you can keep the same bed base, of course, as long as it’s not damaged. Divans have pretty thin wood tops that can crack or bow so, check it carefully. 

In my opinion, a platform base is always the best. If the base is sprung, the whole mattress will start to fold which is usually not what they’re designed to do. A slatted base is slightly better than a fully sprung one, but still not as good as a solid base.

Pillows

Finally, I should mention pillows. Pillows are very subjective to the person, and especially to any neck/upper back/shoulder girdle conditions they may have. 

As a rule of thumb (and this is painting with a very broad brush) people seem to usually have too much pillow depth more often than too little. One medium depth pillow is usually best if you don’t have any specific issues. I find feather works well as you can punch and mould it to the right height and shape, so there is some support under your neck but that’s very much a personal preference.

I rarely see anyone who gets on well with memory foam pillows (there are the odd one or two) or sprung pillows.

The price of a good feather pillow is probably about £50, but as I said right at the start, I want you to not only be in a good position, but also comfortable and pain-free during the night and the next day, so if a £5 pillow works for you then that’s absolutely fine. Don’t forget most pillows can be laundered regularly which may give (especially feather pillows) some of their volume back.

If you are experiencing neck pain though, get your neck examined and treated first and ask your osteopath what pillow they would suggest for you specifically going forward.

BE ‘BED FIT’

The healthier and stronger your back is, the better night’s sleep you will get and the better your back will be when you get up in the morning.
Core strengthening exercises will help support the back during the night and prevent back spasms. Gentle stretching before bed can increase flexibility and help to relax the body and reduce stress.

Take care getting in, and especially out, of bed. Take your time. When you wake up in the morning, allow a few minutes to get your muscles and joints moving fully instead of leaping out of bed at the alarm. Roll onto your side then use your arms to push you upright while your legs drop over the side, then sit there for a minute moving gently before slowly standing up.

Perhaps most importantly, if you do have a back or musculoskeletal issue, get it checked. A health professional can assess why you’re suffering and help treat the symptoms. They can suggest the correct investigations, treatment and exercises, as well as further helping you to choose that all important correct mattress.

Booking an appointment with an osteopath could be the start of ending your back pain for good!

Feeling stressed?

Everyone feels stressed from time to time. In small doses, stress can actually be quite useful; motivating us to achieve our goals. But for some, stress is chronic. Meaning it is debilitating and negatively impacts their mood, their health and wellbeing, their relationships and their work.

Experiencing a lot of stress over a long period of time can also lead to a feeling of physical, mental and emotional exhaustion, often called burnout. It is, therefore, easy to see why reducing stress across all areas of your life would be important. Stress management tips are a good place to start.

Learning how to manage your stress takes practice and time.

Here are our top 10 ways on managing and reducing stress.

10 TIPS TO REDUCE STRESS:

1. Prioritise your health
   

   – make decisions which will benefit your physical, mental and emotional wellbeing. For example, go alcohol-free a few nights each week or allow yourself time for a hobby you enjoy. These small steps for a healthier lifestyle will help in reducing stress levels.

2. Get a good night’s sleep (regularly)
   

   – research clearly shows that sleep deprivation amplifies the symptoms associated with stress. Aim for between 7-9 hours of good quality sleep every night.

3. Practice deep breathing
   

   – when our bodies are stressed, the muscles that help us breathe tighten. By focussing on taking several deep breaths we can quickly and effectively relieve physical symptoms associated with feeling stressed or anxious. Try to do this regularly throughout the day.

4. Drink enough water
   

   – being dehydrated (however mild) causes our cortisol levels to rise, which automatically makes us feel stressed. Your body is already dehydrated if you’re feeling thirsty. So try to avoid reaching this point by hydrating yourself regularly. Aim for 2-3 litres per day, more in hot weather or when exercising.

5. Eat a balanced diet
   

   – dieticians stress how certain foods have stress-relieving properties. For example, dark chocolate is rich in antioxidants, whilst avocados and oily fish are high in omega-3 fatty acids (both of which are proven to help lower anxiety levels).

6. Exercise regularly
   

   – physical activity causes our brains to release mood-improving chemicals called endorphins. These help us to cope with potentially challenging situations. Both Public Health England and the World Health Organisation recommend at least 150 minutes of moderate intensity physical activity each week, in bouts of 10 minutes or more. Choose activities you enjoy to achieve maximum benefit for the mind as well as the body.

7. Adopt a positive mindset
   

   – research suggests that making a conscious effort to think positively can help protect us against a whole host of physical and mental issues, including stress.

8. Manage your time and tasks effectively
   

   – by giving ourselves enough time in which to complete a given task, and by making sure that we don’t try and accomplish too many stressful things at once, we can reduce the likelihood of feeling overwhelmed. 

9. Spend less time online
   

   – many studies have found a strong positive correlation between internet usage and stress levels. Spending less time on our computers and phones is a simple way to practice self-care. Having screen-free time for at least an hour before bedtime has also been shown to improve sleep.

10. Learn to say no
    

    – in a culture that demands we take on more and more responsibilities, having the confidence to say “no” will only become more important. This final tip takes us back to the start, by reiterating the importance of prioritising our health above unrealistic social pressures, and brings us onto developing an essential tool – resilience.

Continue reading about Resilience or read What is Stress?

If you are interested in how Fleet Street Clinic can assist your workplace with stress management and resilience training, get in touch.

Or if you are an individual who needs help managing stress, you can book a GP appointment online. Our doctors will be able to talk through your thoughts, symptoms and emotions and set you on the right path to diagnosis. They will also be able to recommend relevant support services for stress, if appropriate.

Mental Health Awareness Week: What Is Stress?

Look around your office, do you know if anyone is struggling?

You may think those around you – fellow colleagues or your staff – are completely fine. But mental health affects us all and problems in the workplace are actually very common.

According to mental health charity Mind, at least one in six workers are experiencing common mental health problems, including anxiety and depression.

Nowadays, there is increasing recognition of stress and mental health problems, both within the workplace and in everyday life. Currently, following Stress Awareness Month in April, we are approaching Mental Health Awareness Week, which takes place from 13-19th May.

We thought it might be helpful to focus on some positive strategies to help, in terms of stress management and resilience. Whilst being particularly useful and relevant within the workplace, these can all be used in everyday life as well.

WHAT IS STRESS?

In its purest form, stress is the body’s reaction to something it perceives as dangerous or threatening. When we feel under attack, our bodies respond by producing a mixture of hormones such as adrenaline and cortisol. These prepare us for physical action by diverting blood away from our core and into our limbs. It also temporarily shuts down some less vital bodily functions such as digestion.

For immediate, short-term situations, stress can be beneficial to your health, by helping you cope with potentially serious situations.

Yet if your stress response continues, and stress levels stay elevated far longer than necessary, it can take a toll on your health.

WHY IS IT IMPORTANT TO TACKLE STRESS?

Chronic stress can cause a variety of symptoms, contribute to many health problems (such as high blood pressure, heart disease, obesity and diabetes, anxiety and depression) and affect your overall well-being.

Reducing stress can help prevent these harmful effects on both mind and body.

Looking after yourself and ensuring you have good mental health has many benefits – not just for you as an individual, but for the business too. Employees are generally more productive, passionate and motivated when in good health. Even if they’re experiencing mental health problems, knowing they are supported by their employer can help in the recovery process.

STRESS PREVENTION IS BETTER THAN STRESS MANAGEMENT

Ultimately, the best way to manage stress is through prevention rather than cure.

Research shows that those who are better informed about the practical ways in which they can lower their stress levels are far better able to tackle difficult situations with emotional resilience and determination.

Within the workplace, employers are encouraged to make promoting the wellbeing of their employees a core element of the company’s internal operations. Some examples of a proactive approach to stress-management might be:

• To invite people to take active breaks away from their desks
• Offering lunchtime yoga classes or mindfulness sessions
• Group walks in the fresh air.

So what can help you reduce stress? Continue reading our stress, with Our Top Tips For Reducing Stress.

If you are interested in how Fleet Street Clinic can assist your workplace with stress management and resilience training, get in touch. Or if you are an individual who needs help with stress management, you can book a GP appointment online.

Mental Health Awareness Week: Resilience

WHAT IS RESILIENCE?

Resilience is the ability to recover from adversity, hardships, or significant sources of stress.

It means “bouncing back” from difficult experiences, feeling stronger and more capable to cope than before. With life becoming more stressful than ever, it is an important skill to develop which can make a big difference between surviving and thriving within work and general life.

HOW RESILIENT AM I?

Research has shown that resilience is ordinary, not extraordinary, and is not simply a trait we either have or do not have.

So here’s the good news! Resilience can be developed. It involves behaviours, thoughts and actions which can be learned and developed in anyone.

SO HOW CAN I DEVELOP RESILIENCE?

Many studies show that the primary factor in developing resilience is having caring and supportive relationships within and outside the family, including at work. Relationships fostering trust, provide role models and offer encouragement and reassurance help bolster resilience.

Several additional factors are associated with resilience, including:

• The capacity to make realistic plans and take steps to carry them out.
• A positive view of yourself and confidence in your strengths and abilities.
• Skills in communication and problem-solving.
• The capacity to manage strong feelings and impulses.

These are all factors you can develop in yourself, and which can be fostered within the work environment by employers taking an active interest in employees’ wellbeing.

TOP TIPS FOR DEVELOPING RESILIENCE

Here are a few things you could try, to develop your resilience.
Please don’t feel you need to tackle them all at once – trying one or two at a time may be enough to make a big difference!

1) Create connections

– good relationships with family, friends and colleagues are crucial. Accepting help and support from those who will listen to and care about you strengthens resilience. Assisting others in their time of need can benefit you in return.

2) Accept that change is fundamentally part of living

– accepting circumstances that cannot be changed can help you deal with these more effectively whilst focussing on circumstances that you can alter.

3) Avoid seeing stressful events as insurmountable problems  

– try to look beyond the present towards how future circumstances may be a little better. Take note of any subtle ways in which you might already feel better as you deal with difficult situations – signs of good progress.

4) Take decisive action

– this can assist you in giving some control over your response to challenging situations

5) Pursue your goals

– making them small but achievable and most importantly realistic. Each day, ask yourself “What’s one thing I know I can accomplish today which will help me move in the direction I want to go? Take baby steps in the right direction!

6) Nurture a positive outlook

– developing confidence in your ability to solve problems and trusting your instincts helps build resilience.

7) Keep things in perspective

– retaining an optimistic outlook and visualising what you want, rather than worrying about what you don’t want, can all help the brain engage with this.

8) Practice mindfulness and meditation

– Mindfulness means paying more attention to the present moment – to your own thoughts and feelings, and to the world around you. Meditation involves the use of techniques such as mindfulness to train attention and awareness. Mindfulness and meditation are believed to relax and calm the brain, tackling sources of stress while improving clarity focus and even sleep. According to mentalhealth.org.uk, those practising mindfulness have shown increased activity in the area of the brain associated with positive emotions.

9) Take opportunities for self-discovery and personal growth

– by learning something about themselves, people may find that they have grown in some respect. Many people who have experienced tragedies and hardship have reported better relationships, a greater sense of strength even while feeling vulnerable, increased sense of self-worth, a more developed spirituality and heightened appreciation for life.

10) Take good care of yourself

– pay attention to your own needs and feelings. Engage in activities that you enjoy and find relaxing. Exercise regularly. Taking care of yourself helps to keep your mind and body primed to deal with situations requiring resilience.

If you would like further help and support in resilience training in your workplace, get in touch with our Corporate Health department.

Stress: Are we coping?

We all feel the effects of stress in daily life, whether it’s managing children or dealing with a problem at work. Stress is a normal response, in fact, in small doses, stress can be useful. The problems arise when  you start to have a ‘fight or flight’ stress response to situations in everyday life. This can lead to illness, both mentally and physically.

The first step is to recognise symptoms of stress:

• Nail biting and fidgeting
• Over-eating or loss of appetite
• Irritability with other people
• Substance abuse, including alcohol and smoking
• Lack of concentration
• Increased and suppressed anger
• Feeling out of control
• Excessive emotion & crying
• Lack of interest in anything
• Permanently tired even after sleep

By identifying stress-related problems as early as possible, action can be taken to avoid any serious stress-related illness. For Mental Health Awareness week, which runs from 14-18 May, here are some tips to help manage your own personal stress:

• Be active – 30 minutes a day can reduce the emotions and let you take the time to think more clearly
• Take control –  you are your own worst enemy, but you are also the key to empowerment!
• Find support –  Connect with your family and friends, the more help the better the solutions
• Take time for yourself –  remember to have time for yourself as well. Read, relax and get things done on your to do list that may be holding you back
• Create challenges for yourself –  Setting achievable goals, little or big can help build confidence in your abilities
• Avoid unhealthy habits – Cut down on caffeine, smoking, and alcohol. These can enhance the feeling of stress in the long run
• Be positive – Instead of looking at problems negatively, try to see what you can get out of it to help you grow. Be grateful!
• Acceptance – Take ownership of mistakes, or acceptance of things you can’t control.

Our Occupational Health team at the Fleet Street Clinic are able to provide a full range of work health assessments to address the occupational health needs of your staff. Click here for more information.

To book an appointment with one of our friendly doctors, or for further details on what we can offer for our Occupational Health, call us today on  0207 353 5678  email info@fleetstreetclinic.com or book online now.

October is Breast Cancer Awareness Month

You may notice an increased amount of pink during this month, especially iconic pink ribbons, and it’s for a good reason: October is Breast Cancer Awareness Month.

This annual campaign aims to increase the awareness of the disease and to raise funds for research into its cause, prevention, diagnosis and treatment. With the hope that in the not too distant future, a cure will be found!

Breast Cancer is the most common cancer in the UK. 1 in 8 women in the UK will be diagnosed at some point in their lives.

In the UK, over 55,000 women each year are diagnosed with Breast Cancer which is the most common cancer. Thanks to research, more people are surviving breast cancer than ever before, yet there are still nearly 1,000 women who’ll die of breast cancer each month. Breast cancer is often thought of as something that only affects women, but men can get it in rare cases. It is important for males (especially those over 75 years with a high BMI) to check breast tissue for abnormalities as well.

We will be sharing important information on symptoms, causes and lifestyle alteration you can make to reduce your risk.

We are urging everyone, especially women, to check their breasts regularly and get checked out by a professional if something seems unusual for you.

REMEMBER: The earlier breast cancer is diagnosed, the easier it is to treat and the better the chance of successful treatment.

BREAST CANCER SYMPTOMS TO LOOK OUT FOR:

• a new lump or thickening in your breast, upper chest area or armpit
• a change in size, shape or feel of your breast
• skin changes in the breast such as puckering, dimpling, a rash or redness of the skin
• fluid leaking from the nipple in a woman who isn’t pregnant or breastfeeding
• changes in the position of the nipple
• Unexplained pain in your breast or armpit that’s there all or almost all the time

How to check your breasts

Checking your breasts yourself means you’ll get to know what is “normal” for you. As a society we are probably not that familiar with how our body currently is and so that makes it difficult to know what subtle changes happen. It’s most likely that unless a dramatic change has occurred a subtle change will go unnoticed.

So, how do you check your breasts?
There is no special technique and you don’t need any training to start checking your breasts. It may feel like you’re unsure what you’re doing but get to know your body and any breast check is better than no breast check.

The easiest and most accurate way is to divide the breasts into four quadrants; the upper outer quadrant, outer lower quadrant, inner lower quadrant and inner upper quadrant. Examine each quadrant with the flat of your hand. It is important to do this regularly so that you are familiar with what each breast feels like normally. That way, should you notice any changes, (hopefully not), you will pick them up straight away and changes won’t go unnoticed. It is important to remember to check your armpits as well. It is surprising how many breast lumps are discovered after an “axillary” or armpit lymph node is found and checked.

Breast Cancer Now advises the TLC method – “touch, look and check”.

Touch: Can you feel anything new or unusual?
Look: Does anything look different?
Check: Any changes with your GP

You should check your breasts Regularly

Get to know your “normal” by checking your breasts regularly. Get in the habit of checking your breasts at least every month. It can be easier whilst in the bath or shower. 

Your breasts can change throughout your life for many reasons – like the menopause, pregnancy and breastfeeding, or puberty. So, if you check them regularly, you’ll be able to spot any new or unusual changes that should be checked out by a GP.  

For young and pre-menopausal women it is advised to check mid-cycle (a week after their period finishes) if there are any changes this requires checking with your GP. 

As older women are of a higher risk of breast cancer, due to age, it is advised they check even more frequently. Older women should check on a monthly basis without exception. It is advised for men to check also.

Any lump requires attention and checking with your GP immediately.

In addition to regular self-checks, it is important to never miss a mammogram appointment. They may be painful and momentarily uncomfortable, but a mammogram can save your life. If you have a long wait for a mammogram, are unable to access an appointment or just want an additional check, contact the Fleet Street Clinic and we should be pleased to help.

What are the causes of breast cancer?

There are several factors that contribute to increasing your risk of developing breast cancer. There is no single cause, and has to do with our lifestyle, environment and genetics. There are factors which we simply cannot control such as getting older, family history, inherited genes, dense breast tissue, hormones and age at which period started and stopped. However, there are some lifestyle choices that if altered can reduce your risk of breast cancer.

Lifestyle change that will reduce your risk of breast cancer

1. Your weight

Being overweight or obese has a high risk of breast cancer in both men and women (especially after menopause). You can work out your ideal weight using a BMI (Body Mass Index) calculator, this checks your height and weight to see if you are at a healthy weight. For the majority of adults an ideal BMI ranges from 18.5 to 24.9. A BMI between 25 – 30 means overweight. Obesity means a BMI of 30 and above.

2. How much alcohol you drink

Alcohol consumption increases the risk of breast cancer. The risk is greater with each extra unit per day, the latest UK guidelines state no more than 14 units a week. 

3. How much exercise you do

Being inactive contributes to a small increased risk of breast cancer, this qualifies as doing less than 150min of moderate activity on a weekly basis. This does not necessarily mean sport and exercise, anything that makes you warmer and out of breath counts.

Throughout October we’ll be highlighting the reasons to support this campaign across our social media platforms. We will be sharing inspirational stories from those who have survived the disease and those who are currently battling.  We will also hear from those who have supported a suffering loved one during treatment. Sharing these stories humanises the disease and can provide support/tips for those who may be struggling with a current diagnosis. We will be sharing ways of checking for early warning signs. We’ll also be encouraging all to undertake a Well-Woman or Well-Man health checks. Both of which contain a breast examination.

At Fleet Street Clinic, we specialise in women’s health and have four female GPs on-site to facilitate well-woman health checks. Our Executive Well Woman medical is focused on protecting your well-being and involves a full examination including breast examinations and cervical screen tests. Our comprehensive medical is designed to screen for health problems at the earliest possible stage.

Book Your Well Woman Medical Online. Or if you notice any changes to your breast or have any concerns, you should book a GP appointment as soon as possible.

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To find out more from Breast Cancer Now, visit breastcancernow.org

Cutting back on alcohol can be a really effective way to improve your health, boost your energy, loose weight and save money.

In 2016, the Chief Medical Officers in the UK reduced the recommended amount of alcohol you should consume a week due to concerns about the risk of cancer. New research confirmed that even drinking a small amount of alcohol per week can cause an increase in risk of cancer.

From then onwards, it has been recommended that men and women have the same weekly intake of units per week. According to the UK low risk drinking guidelines, you should drink no more than 14 units a week, make sure you have several drink-free days, and never binge drink.
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What does 14 units of alcohol look like?

Because alcoholic drinks come in different strengths and sizes, units are a way to tell how strong your drink is. 14 units is equivalent to six pints of average strength beer or six medium (175ml) glasses of average strength wine.

It’s safest for both men and women to drink no more than 14 units a week, spread over three or more days with several drink-free days, and no bingeing.

Your risk of death from long term illness, accident or injury, is increased if you ‘binge drink’ 1 or more times a week.

How long does alcohol stay in your body:

On average, it takes about one hour for your body to break down one unit of alcohol. However, this can vary, depending on: 

• Your weight
• Whether you’re male or female
• Your age 
• How quickly or slowly your body turns food into energy (your metabolism) 
• How much food you have eaten 

What are the consequences of drinking too much alcohol:

• Low mood/mood swings
• Liver problems
• Heart problems
• Cancers (mouth, tongue, throat, oesophagus)
• Weight gain
• Poor sleep
• Blood pressure instability 

What are the benefits to cutting down on alcohol?

Short-term benefits:

• waking up in a better mood
• being less tired and more energetic throughout the day
• healthier looking skin
• saving some money

Long-term benefits:

• lower your blood pressure
• lower the risk of diseases including cancer, stroke, hypertension and liver disease
• lower your cholesterol levels
• your memory will improve
• better quality of sleep
• help with weight management*

* Did you know? Alcoholic drinks are high in calories, so cutting back on the amount you drink can really help to reduce your calorie intake.

According to our GP & Occupation Health Physician, Dr Claire Braham;

For further detail of how alcohol can have a negative impact on your health, head to drinkaware.co.uk for more information and advice on drinking.

If you have concerns about the amount of alcohol you are drinking or about your health you should speak to a GP. You can book an appointment online.

More information on our GP service can be found here.

How walking can help Chronic Pain 

Firstly, what is chronic pain?

Chronic or persistent pain can be explained as pain that carries on for longer than 12 weeks despite medication or treatment.

The root cause can vary person-to-person, with it sometimes due to illness or an injury. In other cases it can be due to being overweight, having years of poor posture or improper lifting of heavy weights. It can be debilitating but movement is known to help.

As an osteopath, the conversation I seem to have at least once-a-day is; how much exercise should someone who is in pain be doing?

As you can imagine every case is different, and exercise advice varies hugely from person to person and condition to condition. There is a big difference between chronic pain and recovery from injury pain. I am focusing on exercises for people with chronic pain conditions, specifically walking.

Many people with chronic pain are afraid that movement, including walking, will worsen pain. But as many have subsequently discovered, the opposite is very often true. Using your muscles and joints less can often cause pain to becomes worse. Gentle exercise like walking can really help to bring those pain levels down, as well as many other benefits like improving your circulation, strengthening your bones and of course helping to keep those extra pounds off.

Here are tips before you start: 

1. Talk to your healthcare professional first
You should always take the advice of a health professional before starting any exercise. They can ensure it is safe for you to start, and guide you with the types of exercises you should begin with. They will also help you understand your limits and outline suitable goals. As a rule of thumb, if you are in pain, stop!
I, or another osteopath, can check your posture and gait and give you tips on engaging the correct muscles.

2. Get the right shoes
A good pair of supportive trainers will prove invaluable. Walking boots that protect the ankle are only really required if you’re planning to walk on loose surfaces or heading off into the mountains. Otherwise, walking trainers will suffice. To find out more about choosing the right footwear, read our blog on How To Avoid Running Injuries.

3. Start slow
What we’re aiming for is about half an hour to an hour of physical activity five days a week, but this may take some time to achieve. There’s no rush! A good indicator that you are at the right intensity level is that even though your heart rate is up a little, you are still able to carry on a conversation while walking. When starting your walk don’t go full speed immediately. Allow your muscles and joints to warm up for the first few minutes before getting up to speed. This will help prevent damage and injuries.

4. Keep hydrated
You may need to carry a bottle of water, especially for walking in hot weather. If the weather is hot, make sure you also take sunscreen and a hat to stop sunburn.

5. Finally, try to enjoy it!
The more you enjoy it, the easier it becomes. Find somewhere nice to walk, even if that means
driving somewhere. Listen to music/ podcasts/ audiobooks, or even better get a walking buddy to join you for a chit chat along the route.

For more information on osteopathy services, visit the main page.

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OSTEOPATHY 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  +44 20 7353 5678, email info@fleetstreetclinic.com or book an appointment online.

STUDENTS URGED TO GET VACCINATED BEFORE UNIVERSITY

The UK Health Security Agency (UKHSA), formerly known as Public Health England, is encouraging students to get vaccinated before they start University in September to protect themselves against a range of life-threatening illnesses.

Starting university and attending Fresher’s Week exposes students to a host of viruses and bacteria – some of which for the first time. 

As The UKHSA rightfully points out; “First year or returning students can be at increased risk of serious diseases such as meningitis, septicaemia and measles as they mix with large numbers of other students from around the country and overseas.”

Protection for when the term begins is imperative.
So, what are the vaccinations we would strongly advise?

The 3 vaccines students should get up-to-date with are:

1. Meningococcal ACWY (MenACWY) – protecting against 4 common strains causing meningitis and septicaemia
2. Measles, Mumps and Rubella (MMR) – protecting against measles, mumps, rubella
3. Human Papillomavirus (HPV) – protecting against cervical and other cancers caused by the human papilloma virus (HPV) together with genital warts

Get your vaccines before University starts to receive protection in time.

Meningococcal ACWY (MenACWY) & Meningococcal B (MenB)

Cases of meningitis have risen rapidly since 2009 due to a particularly virulent strain of the Men W & Men B bacteria.

The MenACWY 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. You can book online.

The MenB vaccine is also given as an injection to the upper arm but is a 2-dose course for full protection. It protects agains the B-strain of the meningococcal bacteria. You can book online.

Meningitis can progress quickly leading to blood poisoning (sepsis), which can kill within 24 hours.

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.

It is important to know the signs and symptoms of meningitis and septicaemia (sepsis).

Early symptoms of Meningitis include:

• headache
• a high temperature (fever)
• being sick (vomiting)
• a rash that does not fade when a glass is rolled over it (but a rash will not always develop)
• a stiff neck
• a dislike of bright lights
• cold feet and hands
• or muscular pain

Sepsis is a life-threatening reaction to an infection. It happens when your immune system overreacts to an infection and starts to damage your body’s own tissues and organs. Symptoms can be vague but include:

• acting confused, slurred speech or not making sense
• blue, pale or blotchy skin, lips or tongue
• a rash that does not fade when you roll a glass over it, the same as meningitis
• difficulty breathing, breathlessness or breathing very fast

Many people confuse the symptoms with just a hangover or freshers’ flu, which is one of the theories as to why students are so high-risk. So, check-in on your friends who are unwell. Symptoms can progress rapidly so urgent action in getting medical attention is critical – call NHS 111 straight away

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.

Book your MenACWY & MenB vaccination appointment online

Measles, Mumps and Rubella (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.

Book your MMR vaccination appointment online

Human Papillomavirus (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 some forms of cancers; cervical, head, neck & throat or genital warts. More information on HPV can be found here.

The HPV vaccine is offered at our clinic for girls and boys to protect against HPV-related cancers and genital warts. Book your HPV vaccination appointment online

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.

Flu jabs become available from 3rd September and can be booked online.

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.

Book your BCG vaccination or Mantoux Test appointment online

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.

Book your Tetanus vaccination appointment online

Wellness VACCINATIONs AT THE FLEET STREET CLINIC

Fleet Street Clinic offers a friendly environment and a team of experienced medics to administer all wellness 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

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For the full The UK Health Security Agency (UKHSA) statement, click here.

Urgent polio boosters advised for London children

UK Health Security Agency (UKHSA) has announced that all children aged 1-9 years regardless of previous immunisation status are recommended a polio vaccine booster from all London boroughs.

The virus, which can cause paralysis, has been found 116 times in London’s waste water between February and July this year. 

In the UK, the overall risk of paralytic polio is considered low because most people are protected from this by vaccination. However, due to the recent discovery of type 2 vaccine-derived poliovirus in sewage in multiple locations in London, the Joint Committee on Vaccination and Immunisation (JCVI)  have advised that booster vaccinations in all children aged 1-9 years is an appropriate course of action.

The UKHSA says most of the samples detected are the safe vaccine form of polio, but “a few” have mutated enough to be considered dangerous.

Parents should seek the polio vaccine booster as soon as possible – even if their child is up-to-date with their childhood vaccinations. 

The aim is two-fold; to ensure a high level of protection from polio paralysis and help reduce further spread of the polio virus across London and beyond.

Booster Polio Vaccinations at Fleet Street Clinic

We offer two vaccinations in-clinic that offer protection from Polio:

Revaxis Vaccine: Suitable for children from 6 years and above
Protects against:  Diphtheria, Tetanus, Polio
Cost: £45 + £20 appointment fee
Call to book

Repevax Vaccine: Suitable for children from 3 years and above
Protects against: Diphtheria, Tetanus, Polio & Whooping Cough
Cost: £78 + £20 appointment fee
Call to book

Both of these vaccinations are inactivated, and given by injection. They are both licensed as booster doses, and are not intended for primary immunisation.

More information on the Polio vaccines available at Fleet Street Clinic, click here.

Primary Polio Vaccination
Unfortunately, we do not offer the infant/ baby vaccination for Polio – in the UK this would be the Infanrix-Hexa, the 6-in-1 vaccine. We have no suitable vaccination for children under the age of 3, or for those requiring their primary immunisation against Polio. 

Please contact your NHS doctor or an alternative provider to see if they can help you further.

Dr Vanessa Saliba, Consultant Epidemiologist at UKHSA, said:

“It is vital parents ensure their children are fully vaccinated for their age. Following JCVI advice all children aged 1 to 9 years in London need to have a dose of polio vaccine now – whether it’s an extra booster dose or just to catch up with their routine vaccinations. It will ensure a high level of protection from paralysis. This may also help stop the virus spreading further.”

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More information on Polio and the emerging London findings:

What is Polio?
Polio is a serious viral infection that is transmitted through the stool’s of an infected person through contaminated water, food or surfaces. It can cause unpleasant flu-like symptoms and in severe cases, cause paralysis.

What are the symptoms of Polio?
The majority of people with the infection have no symptoms but some feel as if they have the flu, with:

• high temperature
• sore throat
• headache
• abdominal pain
• sickness

In severe cases of polio, the virus can attack the nerves in the spine and brain which can cause paralysis. In some cases, it can cause persistent or lifelong difficulties and even be life-threatening.

Where has Polio been found?
According to the UKHSA statement, in addition to the findings earlier this year of type 2 poliovirus (PV2) collected from the Beckton sewage treatment works, further upstream sampling undertaken by the UK Health Security Agency (UKHSA) and the Medicines and Healthcare products Regulatory Agency (MHRA) has now identified at least one positive sample of the poliovirus, currently present in parts of the following boroughs:

• Barnet
• Brent
• Camden
• Enfield
• Hackney
• Haringey
• Islington
• Waltham Forest

The sampling has also detected the virus in lower concentrations and frequency in areas adjacent to the Beckton catchment area to the South (immediately below the Thames) and to the east of Beckton. However, it is not clear whether the virus has established itself in these areas or if the detections are due to people from the affected area visiting these neighbouring areas.

How many cases of Polio have been identified?
To date, again based on the UKHSA statement, ‘a total of 116 PV2 isolates have been identified in 19 sewage samples collected in London between 8 February and 5 July this year’.

A further 15 sites in London will start sewage sampling in mid-August, and 10 to 15 sites will be stood up nationally to determine if poliovirus is spreading outside of London.

To book your child’s Polio Booster Vaccination, call +44 20 7353 5678 today.

If you have a heart condition you have a greater risk of becoming more seriously ill from flu (seasonal influenza) than the general population. In addition, having the flu can exacerbate pre-existing conditions like diabetes or asthma.

According to the NHS, “every year over 11,000 people in England die from complications caused by the flu virus. Many of these deaths could have been prevented by having the flu vaccination.”

Preventing the flu in the first place is the best option.
The best protection is to have a Flu Vaccine each winter.

What is the flu?
Many people think having influenza, also known as the flu, is like having a bad cold, but in reality flu is a nasty respiratory virus that can make you very unwell. Influenza causes inflammation in the body and can be very serious – sometimes leading to hospitalisation or even death. 

There is evidence that heart attacks happen more often during or immediately after an acute inflammatory illness, such as flu. 

A flu jab is the best protection against flu.
In general, the flu causes stress and inflammation on the body, increasing blood pressure, heart rate and  heart function. This is not good for someone with heart or circulatory problems. 

Flu vaccination is strongly recommended for anyone who has ever had a heart attack, stroke or has underlying heart disease. A previous diagnosis of heart or circulatory diseases is considered a high risk factor for complications or even another heart attack, for anyone who becomes ill with flu. 

Does flu affect heart medication?
If you take warfarin, flu symptoms can affect your blood clotting rate (INR). You should speak to your doctor if this happens so they can monitor your situation closely. It does also mean if you do become unwell, it may take you longer to recover than the average person.

In addition, some over-the-counter flu medicines can’t be used when taking medicines for heart conditions, so contact your doctor before taking things like painkillers and cough medicines. It is better to check before beginning any new medications.

When is the best time to get the flu jab?
Flu vaccinations become available from mid to late September, and through the season until February. It’s best to get your flu vaccine in September or October. The peak time for catching flu runs from Christmas to Easter. The aim is to be vaccinated before flu transmission starts, and to allow at least a couple of weeks post-vaccination, for maximum immunity to develop. The sooner you have the vaccination, the sooner you will be protected. 

You can book your flu jab online.

We have specialist flu vaccinations available, such as an egg-free alternative, FluAd (for those aged 65 year and older), kids nasal spray or the premium recombinant flu jab. You can book these online too.

It is important to have a flu jab every year because the flu virus can change. There are many strains of flu already and some are more dominant than others. Each year strains are analysed to determine which strains are likely to be the prevalent strains circulating that year. They can vary year to year so relying on a past vaccination for protection is risky. The previous year’s vaccine may not offer you the right protection against the strains in circulation this year. 

In addition, immunity to flu decreases over time. Exposure to the flu virus strengthens the immune response and offers natural protection. With less flu circulating over the past few years due to covid restriction measures, natural immunity in the general population will have decreased. 

A flu vaccine will boost immunity.

In comparison to the previous year many workers have now returned to the office, social distancing restrictions have eased and in general there are less protective measures set in place. This means that there is a greater chance of the flu spreading and more people falling ill this winter. Although there has been a massive easing of covid restrictions this year that doesn’t mean that the pandemic is over. With both illnesses circulating around it is highly recommended to reduce the risk by getting the flu jab.

Protect yourself against the flu.
You can find more information on the types of flu vaccines available. 

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Wanting to book a Workplace Flu Vaccination Programme?

Flujabs.org is part of Fleet Street Clinic and has been providing workplace flu vaccinations to UK businesses for many years. 

Request a quote – Fill out the online  form and one of our flu coordinators will get back to you with current availability and costs.

With (hopefully!) sunnier and longer days upon us, summer is a great time of year to get your running shoes on. As a keen runner myself, I understand the appeal; it’s pure, it’s meditative, and it gets your blood pumping like little else.

Unfortunately, for all its positives, running can be problematic for the body and it tends to bring out minor issues and turn them into major ones. These often include achilles tendonitis, shin splints, plantar fasciitis, ITB syndrome, stress fractures, hip and lower back issues, and more knee problems than I have time to list.

Many of the problems from running come from two areas. Firstly, heel strike which is where the heel hits the ground repeatedly and sends a shock through the whole skeleton which causes issues from the heel itself all the way up to the lower back. Secondly, gait – which is the way a person walks; the whole lower limb (especially the knee) is quite finely tuned to work in certain ways, and anything that affects that can begin to cause problems. A dropped arch, tight muscle, old injury, slight one-sidedness etc can bring these issues on.

What can be done to prevent these issues? 

Like always, the number one rule is to get any symptoms you are experiencing looked at as soon as possible. Early diagnosis, advice and treatment is vital.

One thing that can really help heel strike and gait is by getting the right trainers. Here’s a few things to consider:

1. Don’t confuse fashion and effectiveness. Good running trainers generally don’t look cool! Some of the bigger brands will advertise to you that they are great for sports but do your research. I would usually recommend Asics or Brooks.
2. Replace your shoes regularly. The soles of most trainers are good for about 200-250 miles maximum. So, if you’re running 20 miles per week, you’ll probably need to replace them after 4-6 months.
   The shoe may still look okay after that but there is an increased risk of injury. It is, therefore, important to ensure that you are replacing your trainers as regularly as required.
3. You don’t need to buy the most recent model. Many of the best running trainers are on their 20th/30th or so iteration. When a new model is released the price of the last couple of iterations will drop quite significantly, and will still be an excellent option.
4. Good arch support. Trainers largely work on preventing pronation etc. by the way they flex. Many have little if any arch support, even with good ones you may need an additional orthotic insole made for your specific needs. This may also mean you need half a size bigger.
5. Speak to the experts. A running machine in a shoe shop is useful, but remember the shop assistant has probably only had a brief introduction in what to look for, and no idea of your other contributing factors. Speak to a specialist – an osteopath, podiatrist, or physio.

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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 +44 20 7353 5678, email info@fleetstreetclinic.com or book an appointment online.

Travelling with children can be an enlightening and wonderful experience for the family – creating memories and opening their minds to other cultures and ways of life. But on the flip side it also can be quite daunting, especially if this is your first time travelling with children. The best way to establish a safe travel experience abroad is to take early precautions.

Before Your Travels

When it comes to travelling with children, careful planning and preparation should be considered. It is highly advised to have a travel consultation well in advance of your travels. The travel nurse will make you aware of any travel risks and take into consideration your child’s current wellbeing. Depending on where you are travelling, your child may require certain vaccinations. 

These preventative measures will safeguard your child from any diseases or illness. 

Your may be advised the following vaccinations: 

• Rabies
• Yellow Fever
  –  Some countries require this as a condition of entry and will ask for proof of vaccination when you arrive into the country.
• Hepatitis A 
• Typhoid 
• Tick-borne Encephalitis 
• Japanese Encephalitis 
• Hepatitis B
• Meningitis ACWY
• Cholera

All vaccinations require a duration of time following vaccination to reach full protection, usually 10 – 14 days, so factor this time in before your travels. In addition, some vaccinations require a multi-course dose before they are considered effective, such as rabies which requires 3 vaccinations to be considered a complete course. Book a travel consultation early to ensure you have enough time before you travel.

In addition to travel vaccinations it is worth discussing any upcoming childhood vaccinations that could be beneficial to have at the same time so your child is protected against any other common diseases that aren’t necessarily associated with just travel.

If you intend to go to countries with a high malaria risk it is important to discuss antimalarial protection  during your travel consultation. Malaria can be fatal and there is a higher risk for children. Antimalarials (malaria tablets) are generally taken for a duration before, during  and after your trip  and need to be purchased in advance of your travels. There are a number of different types and are suitable for different people so it is important to discuss your options with a travel health expert. The tablets work by ensuring the malaria parasite doesn’t reach unmanageable numbers, keeping you healthy whilst you travel. 

Travelling abroad can be exhausting, especially for young children. Jet Lag is known to cause temporary sleep disturbance, which can have an impact on your mental health and other bodily functions. To prepare ahead, The Jet Lag Calculator can tell you how long it will take the body to adjust to your new time zone when you travel – and to adjust back again when you come home.

To undergo a Pre-Travel Consultation, book online or for more information on Travel Health Services.

During Your Travels

Travelling can sometimes result in unexpected situations. For the protection of your child/ren and your family in general, always carry a First Aid Kit. This will reduce your need to seek medical aid for minor accidents or journeys to a chemist, especially if local towns are at a further distance.

When travelling to warmer climates, sun safety is crucial as young children are more vulnerable to sunburn from outdoor activities. To protect the skin apply sunscreen of at least SPF 30, with broad spectrum UVA and UVB protection throughout the day. In addition, hot weather can also pose a risk of dehydration and heat stroke. Ensure you and your child are hydrated throughout the day by drinking  water from a safe source. This can be bottled water, boiled water, or water that has been filtered. 

To further avoid traveller’s diarrhoea:

• Wash your hands regularly, especially before eating
• Carry an alcohol-based sanitiser 
• Keep children from crawling or sitting on the ground
• Avoid swimming in contaminated water
• Don’t swallow any shower or pool water
• Eat raw fruits and vegetables only if washed in clean water or peeled 
• Stick to foods that are well cooked and served hot
• Stick to canned or bottled beverages
• Avoid food that has been sitting on a buffet to avoid contamination

We have launched a new, free online consultation for Travellers’ Diarrhoea – by answering a few simple medical questions about yourself, we can check if antibiotics are recommended for your trip. You can pay online and we’ll dispatch them directly to you if you are suitable. 

Alternatively, you can have a more comprehensive travel consultation in-clinic with one of our experienced travel nurses. 

For more information on the prevention and treatment of Travellers’ Diarrhoea.

The feeling of discomfort from bug bites can truly be a nightmare whilst travelling. Insect bites such as mosquitoes, ticks, biting fleas and kissing bugs can cause pain, irritation and even spread diseases. However, they can be avoided through protective clothing. Our Ultimate Bug Kit  has everything you need from repellents to aftercare. Alternatively, you could purchase individual items and create your own kit.

After Your Travels 

Travelling can expose your child to certain diseases. If your child falls unexpectedly ill – contact your doctor or emergency services right away. A high temperature/ fever could mean an infection. For most people, travellers’ diarrhoea usually clears up within a few days. However, if your stomach bug has been ongoing for weeks after returning home, then you will need to do testing to investigate the root cause. Viruses, bacteria or parasites all cause similar symptoms but require an entirely different treatment approach. Our Gastrointestinal (GI) Panel PCR test looks for any microbes that are causing your symptoms and can quickly identify the exact cause of your Travellers’ Diarrhoea. Results can be provided in as little as 1-hour, so that accurate and effective treatment can begin straight away.

WHAT IS DIABETES? 

Diabetes is a lifelong condition that occurs when the body is unable to properly regulate the amount of glucose (sugar) in your blood. Poor control of diabetes can lead to high blood sugar levels and cause long term damage to your overall health and organs. 

WHAT HEALTH PROBLEMS DOES IT CAUSE? 

High blood sugar levels can cause a lot of damage to your body and if not managed correctly, may lead to many diabetic complications. This will cause long term health problems, especially if they go untreated. 

HOW DOES DIABETES AFFECT OTHER PARTS OF YOUR BODY?

Eyes: Retinopathy is a complication of diabetes caused by high blood sugar levels damaging the retina, often leading to vision impairment. It is the leading cause of blindness among working-age adults in the UK. As a consequence of diabetic retinopathy, swelling can take place, called diabetic macular oedema. People with diabetes are also more prone to develop cataracts and glaucoma at an earlier age, contributing to vision reduction.

Feet: Foot health is often a neglected area anyway but high blood glucose levels can lead to insensitivity in the foot and lower limbs, which means you lose the ability to feel pain and distinguish hot or cold.  It can also lead to less blood supply to your feet leading to poor circulation. 

Loss of sensitivity means that you may not notice if you have a minor cut, sore or wound and poor circulation means if you do get a cut or sore, it will take longer to heal and open wounds are more likely to become infected. This combination is why there is an increase in risk of amputation for those who are diabetic. Regular podiatry appointments are the best way to look after your foot health.

Heart: High blood sugar levels can also cause problems to your blood vessels which can sometimes lead to serious problems such as heart attacks and strokes. 

Kidneys: High blood sugar levels creates more difficulty for the kidneys to clear waste. This may lead to Diabetic Nephropathy, the deterioration of the kidneys.

HOW CAN DIABETES BE TREATED? 

There is currently no cure for diabetes, therefore, the best way to deal with diabetes is to get it properly managed and controlled. If you are diagnosed with type 1 diabetes, you must either inject or pump insulin into body to treat your diabetes. If you have type 2 diabetes, you may also have to use insulin, however, it can be managed through diet and lifestyle changes. 

HOW CAN YOU TEST FOR DIABETES?

An instant HbA1c test can confirm if you’re within the recommended range, or are considered pre-diabetic or confirm that you have diabetes. Using a small blood sample it will measure how well your blood sugar has been controlled over the last 3 months and provide a numerical reading.

As the HbA1c test provides 3-months insight, it is an important blood test for diagnosed diabetics. It provides a good indication of how well they are managing their diabetes.. 

Many people are more familiar with the glucose blood test – it measures the concentration of glucose molecules in your blood at a single point in time. The amount of glucose in your blood could also indicate whether you could be diabetic or not. People with diabetes can also use this test to manage their condition on a daily basis alongside regular HbA1C testing.

You can book an instant HbA1C test online at a cost of £54.50.

WHAT ARE THE SYMPTOMS?

When it comes to diabetes the symptoms are not always obvious and can often go unnoticed for long periods of time before being diagnosed. 

The most common symptoms include:

• Feeling constantly thirsty or dehydrated 
• Unintentional loss of weight and increased appetite (type 1)
• Vision begins to blur
• Numbness in your hands or feet (type 2)
• Fatigue 
• Urinating more frequently 

WHO IS AT RISK?

In the UK, type 2 diabetes is the most common type of diabetes, affecting over 90% of sufferers. The symptoms of diabetes are often mild, therefore, it’s important to be aware of the risk factors that could make you more susceptible to diabetes in the future. 

According to Diabetes UK, type 2 diabetes is twice more likely in people of African descent in comparison to people of European descent and six times more likely in South Asian communities, making them a high risk category in developing diabetes. Additionally, people of African – Caribbean and South Asian descent are also at risk of type 2 diabetes much earlier, usually over the age of 25. On the other hand, for Europeans the risk increases when over the age of 40. Other factors contributing to diabetes include being overweight, high blood pressure and genetics. 

Other general risk factors include:

• Having high blood pressure
• Carrying extra weight around your middle
• Smoking 
• Polycystic Ovary Syndrome (PCOS) sufferers
• Those with a sedentary lifestyle
• Drinking too much alcohol
• Those with disturbed sleep – this includes those who do not get enough sleep and those whose sleep too much

If you have symptoms of diabetes or general concerns about your diabetic risk, you can book a GP appointment to discuss in more detail. 

Alternatively, you can book in for an instant HbA1c test with a nurse. 

From Sunday, June 12, 2022 at 12:01AM ET all COVID-19 testing entry requirements for international travellers to the United Stated were rescinded. 

Arrivals no longer need to show proof of a negative Covid-19 test or documentation of recovery prior to boarding a flight to the U.S nor upon arrival. 

The Centre For Disease Control (CDC) has reached the decision based on the high vaccine uptake and widespread population immunity. 

In the statement they released, they explain; “The COVID-19 pandemic has now shifted to a new phase, due to the widespread uptake of highly effective COVID-19 vaccines, the availability of effective therapeutics, and the accrual of high rates of vaccine- and infection-induced immunity at the population level in the United States. Each of these measures has contributed to lower risk of severe disease and death across the United States. As a result, this requirement which was needed at an earlier stage in the pandemic may be withdrawn.” 

Most countries, including the UK, have already abandoned testing requirements in a bid to return international travel to pre-Covid levels and it seems the CQC have decided it is now time for the U.S to do the same.

Does this mean that the COVID-19 pandemic has ended? 

No, but it does signify a shift in the pandemic. As we see a worldwide reduction in covid cases and death rates, the CDC statement clarifies that whilst testing may not be necessary right now, they will continue to monitor the data and adapt accordingly. 

They state; “CDC continues to evaluate the latest science and state of the pandemic and will reassess the need for a testing requirement if the situation changes”.

What about covid vaccinations…
Do I need to be vaccinated to travel to the U.S? 

Yes, foreign travellers from outside of the U.S are required to be double vaccinated from COVID-19 to enter the country. But for people under the age of 18, U.S citizens/ nationals or lawful permanent residents will be exempt from vaccination requirements. Currently, the Covid Booster vaccination is not a requirement and there is no set expiry date on the first dose of vaccination. 

Overall, the easing of the US Covid restrictions is welcome news to the travel and tourism industry and demonstrates the possibility of international travel returning back to its pre-covid levels. 

However, the absence of masks, vaccines, or travel mandates does not mean that the risk of catching Covid-19 has gone away.
We strongly recommend:

• Having comprehensive travel health insurance for all travel to the USA – hospital care should you require treatment for Covid is very costly.
• Wearing a high filtration (N95 or FFP3) mask during your journey
• Practising all the usual hygiene recommendations during your journey (e.g. hand sanitisers, distancing where possible
• Having an early test and avoiding travel if you have even minor symptoms.

For more information on the covid testing services available at Fleet Street Clinic.

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 more 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

Myth 2: Monkeypox is a new virus.

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.

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) 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.

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.

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.

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.

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.

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. 

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

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