Ditchling Pharmacy

Diabetes 4

Reducing your risk of stroke

If your cholesterol is too high, then the extra fat in your blood sticks to the walls of your blood vessels. Over time this fat hardens to form a plaque blocking your blood vessels, making the space narrower and the blood flow slower. This can cause some of the blood cells to form a clot, which could travel through your blood vessels till it reaches a space too narrow and causes a blockage. This will starve the brain of oxygen leading to a stroke.

To avoid this happening:
• Get your HbA1C, blood pressure and cholesterol measured as part of your annual diabetes review
• Don’t smoke
• Eat a healthy balanced diet
• Be physically active

Take your medication as prescribed. Some medicines help to protect your body by reducing high blood pressure and you may take these even if you don’t have any blood pressure problems.

Diabetes 3

Do daily check-ups of your feet

Diabetes means you have too much sugar in your blood, which can damage your nerves, especially in your extremities. This is why it is important you have regular check- ups on your feet and eyes. It is a good idea to sit down and have a proper look at your feet every day. If you spot any of the following changes you need to see your GP:
• Tingling sensation or pins and needles
• Pain
• A dull ache
• Shiny, smooth skin on your feet
• Hair loss on your legs and feet
• Loss of feeling in your feet or legs
• Swollen feet
• Your feet don’t sweat
• Wounds or sores that don’t heal
• Cramp in your calves when resting or walking.

And if you notice any of these changes, see your local foot team urgently:
• Changes in the colour and shape of your feet
• Cold or hot feet
• Blisters and cuts that you can see but don’t feel
• Foul smell coming from an open wound.

One of the things that you can do to reduce the chance of getting ulcers on your lower legs and feet, is to moisturise below your knees and feet every day with something like Nivea cream but not between your toes. This will keep your skin soft and supple so if you do knock it, a break in the skin is less likely to happen which means an ulcer is less likely to develop and the healing process will be quicker.

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Diabetes 2

Diabetes Risk Factors

About 90% of people with diabetes have type 2 diabetes. The signs may not be obvious, or there may be no signs at all. Some people can live with it for up to 10 years before being diagnosed. That’s why it’s very important to know your diabetes risk factors. As you get older you are more likely to get diabetes, also if you are male, belong to a non -white ethnic group, have close relatives with diabetes, have a waist measurement more than half your height, a BMI of more than 25 and high blood pressure.

Now obviously there is nothing you can do about age, s*x and ethnicity but you can adjust your weight so that your waist measurement and BMI is more in line with recommended measurements. This will also help reduce your blood pressure.

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Diabetes 1

Diabetes

The estimate for the number of diabetics in the UK is 4.4 million and roughly 1.2 million that may have diabetes but have not yet been diagnosed. These patients need to have regular annual check ups to make sure they do not suffer from the complications that diabetes can cause. For example, there are more than 184 amputations and 770 strokes due to diabetes in the UK every week but many of these are preventable with the right care.

These complications cost the NHS £6.2 billion per year from on overall spend on diabetes of £10.7 billion which is about 6% of the whole UK health budget. There are estimates for the cost of diabetes rising to £18 billion by 2035. Much of this money could be saved if patients with diabetes followed the instructions of their doctors and nurses gave them. In many cases, you don’t even have to lose weight, just alter your eating habits so you reduce the amount of carbohydrates you eat and exercise a bit more. Again, not necessarily going to the gym but going upstairs more often, having a walk at lunch time, walking to the local shops rather than driving.

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Pharmacy First 5

Quiz

Q1. What is Pharmacy First?
A1. It is a new service that has been introduced so you get a supply of certain medicines for certain minor ailments.
Q2. What are minor ailments?
A2. These are conditions that will usually resolve themselves like coughs, colds, insect bites, nasal congestion.
Q3. What is the point of this new service?
A3. It aims to reduce the workload of GPs.
Q4. What conditions can I get a supply of antibiotics for?
A4. Urinary tract infections (UTIs), impetigo, shingles, insect bites, sinusitis, ear infections and sore throats.
Q5. Can we just walk in and get an antibiotic?
A5. No. Your infection has to meet certain criteria set by the government.
Q6. Who can get help for a UTI?
A6. You must be a woman between 16 and 64 years and it must be your first infection in the last 6 months.
Q7. Who can’t get help for a sore throat?
A7. Children under 5 and pregnant women under 16.
Q8. What are the criteria for acute earache?
A8. Children aged 1 to 17 with severe infection who have had less than 3 episodes in 6 months.
Q9. Who can get help for shingles?
A9. Any adult over 18 years old.
Q10. What are the restrictions on pharmacists helping people with impetigo?
A10. Anybody with bullous impetigo, recurrent impetigo (2 or more episodes in the same year), pregnant women under 16.

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Pharmacy First 4

Quiz

Q1. What is Pharmacy First?
Q2. What are minor ailments?
Q3. What is the point of this new service?
Q4. What conditions can I get a supply of antibiotics for?
Q5. Can we just walk in and get an antibiotic?
Q6. Who can get help for a UTI?
Q7. Who can’t get help for a sore throat?
Q8. What are the criteria for acute earache?
Q9. Who can get help for shingles?
Q10. What are the restrictions on pharmacists helping people with impetigo?

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Pharmacy First 3

What is the procedure if I have one of these conditions?

Our pharmacist will take you into the consulting room and ask you questions to assess if you are seriously ill. If they think you may be, they will send you back to your GP or to A&E. If they think it is less serious, they will continue to ask you questions to ascertain the severity of your symptoms.
Depending on the answers you give, our pharmacist will either:
• Offer advice and an OTC remedy to ease your symptoms while your body fights off the infection, asking you to return in a few days if you are still not well.
• Review your symptoms and if they pass a “gateway point” set by the protocol determined by NHS, our pharmacist can prescribe you an antibiotic.
Examples of the criteria for each condition are:
• If you have impetigo with 3 or less lesions you may be offered hydrogen peroxide cream for 5 days. If you have 4 or more, you could be offered an antibiotic.
• If you have an uncomplicated UTI with mild symptoms, you could be asked to return in 48 hours if there is no improvement but if the symptoms are moderate to severe you may be given nitrofurantoin.
• If you have acute, severe symptoms of a sore throat, you may be offered an antibiotic.
• If your child has mild earache, you may be offered self-care advice and pain killers but if it is more severe and/or your child has had it for more than 3 days, you may be offered an antibiotic
• Most insect bites are not serious and will get better in a few hours/days but if there is redness and swelling around the bite or pus discharge, you may be offered an antibiotic.
• If you think you may have shingles and our pharmacist agrees, it is with in 72 hours of the onset of the rash and you are over 50 OR it is one week after the onset of the rash, and you are over 70 you may be offered an antiviral.
• If you have been suffering from sinusitis for less than 10 days, you could be offered self-care advice and pain relief but if the symptoms have lasted more than 10 days and are getting worse you may be offered an antibiotic.

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Pharmacy First 2

What are the conditions that pharmacists can supply antibiotics for on the NHS?

The Government has decided that there are 7 minor ailments that pharmacists can supply antibiotics on the NHS provided strict criteria are met. The ailments are:
• UTI - only to women aged 16-64 who haven’t had a UTI in the last 6 months
• Impetigo - as long as it’s non-bullous, you haven’t had an episode in the last year, and you are not pregnant under 16
• Shingles - any adult over 18 except pregnant women.
• Insect bites - anybody over 1 year old excluding pregnant women under 16
• Sinusitis - for anybody over 12 excluding immunocompromised people, chronic sinusitis (symptoms have lasted for more than 12 weeks) and pregnant women under 16
• Ear infections - for children aged 1 to 17 excluding those who have had 3 or more infections in 6 months or 4 or more in 12 months and pregnant women under 16
• Sore throat - for adults and children over 5 excluding women under 16 who are pregnant

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Pharmacy First 1

What is Pharmacy First?

It is a new service that the government has introduced to help relieve the pressure on GPs and other emergency settings. Hopefully it will also mean that you will be seen by a highly qualified healthcare professional without an appointment and more quickly than previously.
The system is intended to work like this: You visit your GP, Out of Hours, a walk-in centre or you contact NHS 111 and the person you speak to, after asking several questions, decides you have what is called a minor ailment and refers you to your local pharmacy.
A minor ailment is one that will usually clear up on its own, after a few days but you may feel that you need some sort of medication to ease the symptoms. In this case you will be referred to your local pharmacy for advice and some over the counter remedy to help.

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Insect Bites 6

Quiz

Q1. What insects can bite?
A1. Midges, mosquitoes, fleas and bedbugs.

Q2. What insects can sting?
A2. Bees, wasps and hornets.

Q3. How do insects bite?
A3. Make a small hole in your skin to feed.

Q4. What causes the sting?
A4. Injecting venom into the skin.

Q5. What are the symptoms of insect bites?
A5. Pain in the area where the bite has occurred, a small, swollen lump on the skin.

Q6. What should I do if I am bitten?
A6. Clean the skin, keep the affected area raised.

Q7. When should I get medical advice?
A7. The bite or sting starts swelling or blistering, if there is pus.

Q8. What treatment is there for insect bites?
A8. Take painkillers if painful, use antihistamines to relieve itching, use hydrocortisone cream to reduce itching and swelling.

Q9. How can I avoid being bitten?
A9. Avoid insect hotspots, keep windows and doors shut, cover up with appropriate clothing, wear insect repellent.

Q10. Which countries could put me at risk of malaria?
A10. Africa, Asia and South America.

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Insect Bites 5

Quiz

Q1. What insects can bite?
Q2. What insects can sting?
Q3. How do insects bite?
Q4. What causes the sting?
Q5. What are the symptoms of insect bites?
Q6. What should I do if I am bitten?
Q7. When should I get medical advice?
Q8. What treatment is there for insect bites?
Q9. How can I avoid being bitten?
Q10. Which countries could put me at risk of malaria?

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Insect Bites 4

Travelling abroad

There’s a risk of catching diseases such as malaria from insect bites in certain parts of the world, such as:

• Africa
• Asia
• South America

It’s therefore necessary to be aware of any risks before travelling to these areas, and to get any necessary medication or vaccinations prior to travelling.

To learn more about this or any other health condition that is concerning you, have a chat with one of our trained team.

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Insect Bites 3

Preventing insect bites and stings

Most insects are more active during the early mornings and late evenings. If you are outside, try to sit somewhere in the sun with a breeze as some insects don’t like these conditions.

Insect hotspots

Be wary of insect hotspots such as outdoor areas where food is served e.g. a pub garden. Cover food and drink when eating or drinking outside, especially sweet things such as fizzy, sugary drinks.

Insect nests

Never disturb insect nests - such as a wasp nest in trees or in a roof space. If a nest is in, or near to, your house, arrange to have it removed professionally.

Keep insects out

Doors and windows should remain closed or covered with thin protective netting to prevent insects getting inside the house. Keep car windows closed to stop insects getting inside.

Cover up

Cover exposed skin by wearing long sleeves and trousers. To avoid tick bites, it is advisable to cover up in long grassland. As well as this, always check yourself and pets following a grassy walk.

Insect repellent

Be aware that product such as soaps, shampoos and deodorants with strong scents can attract insects. Insect repellent is worth using if you are spending a lot of time outdoors. Apply repellents that contain 50% DEET (diethyltoluamide) as they are most effective. Apply to exposed skin and clothing.

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Insect Bites 2

What to do if you’ve been bitten or stung by an insect?

You can often treat an insect bite or sting without seeing a GP.
If anything is left on or in your skin, the first thing you need to do is remove it carefully.
If there is nothing in your skin, or you’ve removed it, wash your skin with soap and water to help lower the chance of infection. The bite or sting should get better in a few days. There are some things you can do to ease your symptoms:

DO:
• Put an ice pack wrapped in a cloth or a clean cloth soaked in cold water on the bite or sting for at least 20 minutes, if its swollen
• Keep the area raised if you can
• Take painkillers such as paracetamol or ibuprofen if the sting is painful
• Use antihistamines to relieve any itching (but do not use antihistamine cream if you had caterpillar hairs on your skin)
• Use a hydrocortisone cream to reduce itching and swelling

DO NOT:
• Scratch the bite or sting as it could get infected
• Use home remedies such as bicarbonate of soda to treat the bite or sting.
• You should speak to a pharmacist if:
• You’ve been bitten or stung and there’s a lot of swelling or blistering
• There’s pus, which indicates infection, your pharmacist can treat this in some instances

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Insect Bites 1

Insect Bites and Stings

Insect bites or stings are not usually serious and get better in a few days. But sometimes they can become infected or cause a serious allergic reaction.
In the UK, insects that bite include midges, mosquitoes, fleas, bedbugs and although not strictly insects, spiders, mites and ticks, which are arachnids. Insects that sting include bees, wasps and hornets.

An insect bites you by making a hole in your skin to feed. Most insects sting as a defence by injecting venom into your skin. Bites from some insects can also cause illnesses, such a Lyme disease from ticks, scabies from mites, and malaria from mosquitoes in certain parts of the world. The main symptoms of an insect bite or sting are:
• Pain where you were bitten or stung
• A small, swollen lump on the skin

The lump may look red. It may be more difficult to see on black or brown skin, but you should be able to feel it.

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