Many conditions get better on their own and can be treated successfully at home without the need to see a doctor. Advice about simple medicines that can be bought without a prescription (and cheaper than a pack of cigarettes!) can be obtained from your local chemist (or out of hours late night chemist on Streatham High Road).

To Avoid Unnecessary Worry

Parents of young children are encouraged to always keep a supply of paracetamol syrup (Calpol), a thermometer, Dioralyte or Rehidrat salt replacement sachets and calamine lotion (for itching of chickenpox) in the house. Parents of babies are encouraged to attend all postnatal events and baby care classes, make sure that their child receives all his/her injections, and learn how to deal with simple but common baby problems eg. feeding, nappy rash, wind, teething and sleeping, as well as temperatures, diarrhoea and blocked or runny noses. The health visitors are available to help you with all such problems.

Temperatures

A temperature occurs commonly even with mild infections in small children.

1. Remove all clothing down to nappy.
2. Give the correct dose of paracetamol syrup (Calpol) for the age and repeat four hourly.
3. If they still appear hot, gently sponge with lukewarm or tepid water regularly, or put them in front of a fan if you have one.
4. Make sure the central heating is turned off and the room temperature is kept down. Only if you have carried out the above treatment or the child appears very unwell with the temperature remaining high, do we need to see the child. A child or adult with a temperature will not come to any harm being wrapped up and brought to the surgery by car or pram.

Antibiotics

These are commonly prescribed and powerful medicines. They only work against germs called bacteria and are ineffective against viruses. This means that antibiotics do not help the common infections caused by viruses eg. colds, runny noses, most coughs,flu, most sore throats, most ear infections, rashes, chickenpox, measles, German measles etc. Antibiotics are not used to treat temperatures. The correct treatment for these is by simple remedies to help with the symptoms until the condition runs its course. We only use antibiotics when we suspect that there is a secondary bacterial infection and if simple measures have failed. Overuse of antibiotics when unnecessary may lead to them not working in the future when really needed and complications eg. thrush, skin rashes, diarrhoea etc.

Colds, Flu & Sore Throats

In adults and children these are usually caused by viruses and so antibiotics are not helpful. Taking regular doses of paracetamol for temperatures and aches, drinking plenty of fluids and resting is all that can be done. Do not worry if you do not eat for a few days: you will come to no harm. If you are blocked up, a decongestant eg. Sudafed or Actifed from the chemist may help. You should be on the mend after 7-10 days, and usually better by two weeks. We would want to see you if you are getting worse instead of better by then. Sore throats usually get better within 5-7 days and may be accompanied by swollen glands in the neck. Gargling with soluble paracetamol, antiseptic mouthwashes or Chloroseptic throat spray (from the chemist) may help with the pain. Looking at your throat in the mirror is useful. If there is pus (green/yellow/white patches) on the back of your throat or you have enlarged tonsils, we may need to see you.

Coughs

Cough medicines do not cure coughs! (Coughs with runny noses are usually caused by viruses for which there is no cure.) Coughs may be soothed by cough medicines bought at the chemist or by a drink made from honey and freshly squeezed lemon juice in hot water which is cheaper. Cough sweets (not for children) eg. FishermanÍs Friend, Lockets etc., may also soothe tickly coughs until they run their course. If your cough persists more than seven days and you bring up coloured phlegm, or you were wheezing, we will need to see you. Children with coughs who may have a runny nose, are a little off colour, not eating or vomit with the strength of coughing or have a temperature but are otherwise all right, should be treated as above but must also have their temperature controlled and be given small amounts of fluids regularly.

Headaches

Most headaches are due to simple causes ranging from tension and eye strain to migraine, or go together with a "hangover" or flu-like illness. Simple painkillers from the chemist taken at regular intervals, rest and relaxation is usually all that is needed.

Diarrhoea

Most cases of diarrhoea can be treated by stopping eating for at least 24 hours and drinking plenty of clear fluids eg., water, ribena, orange squash etc., or Dioralyte from the chemist. If particularly bad Imodium capsules or kaolin mixtures can be bought from the chemist without a prescription. If the vomiting exists as well then sips of fluids regularly will prevent dehydration until the condition settles. In cases of a recent holiday abroad or if the diarrhoea persists for more than 10 days, you will need to see a doctor. In babies or children medicines cannot be given to stop diarrhoea or vomiting. In these cases stopping all solid food and milk (except breast milk) for about 24 hours and giving clear fluids regularly, even sips at a time, is all that can be done. Dehydration in children in the UK is avoidable, and prevents the need for a child to be admitted to hospital to be given fluids through a needle in the arm if the simple instructions above are followed. If a child vomits persistently ie.10-20 times in less than 6-8 hours and is unwell, we need to see him/her.

Back Pain

For the first few days rest your back by lying on a firm mattress placed either on the floor or on wooden boards between the mattress and the base of your bed. Aspirin, paracetamol or ibuprofen will help relieve the pain, and gentle heat eg. from a hot water bottle or heat lamp will often help. As the pain begins to ease, start gentle exercises as soon as possible even if you can only move your back a few inches in each direction. Avoid straining your back while exercising and take great care when lifting even if the pain has completely settled. When sitting, an upright chair with the support for the small of the back puts much less strain on your spine. If the back pain does not start to improve within a few days, then consult your doctor for advice.

Bruises

Bruises are very common in children. They normally get better in 7-10 days. If a child gets up at once after a fall and moves about normally, it is unlikely that a bone has been broken but the child may be stiff the next day because of the bruising. Severe bruising can be treated by rest for 24-48 hours. In the case of a badly bruised leg, the limb should be raised. A cold compress may ease a bad bruise if applied at once.

Burns & Scalds

Run cold water over the burnt area until the pain subsides (this may take 15 minutes). If the area becomes blistered, keep it clean and dry and do not burst the blisters. If the burn is more than a few inches across or if the skin is broken, consult your doctor or the Casualty Department at the hospital as soon as possible.

Conjunctivitis

This makes the eyes red, sore and 'mattery'. It often settles without treatment if you bathe the eyes with boiled water and wipe away the 'matter' with cotton wool. If it does not settle, consult a doctor. It is often very infectious, so patients should never share towels or flannels and should wash their hands immediately after touching their eyes.

Chickenpox

On the first day a rash appears as small red patches about three to four mm across. In a few hours small blisters appear in the centre of these patches. During the next two to four days further patches will appear and the earlier ones will turn crusty. Calamine lotion may be applied to soothe the itching; cool baths may also help. The most infectious period is two to three days before the rash appears and up to five days after this. Children may return to school six days from the day when the rash first appears.

Cuts

Bleeding can usually be stopped by applying pressure to the cut with a clean handkerchief for two to three minutes. Apply a plaster dressing firmly, bringing the edges of the cut together with a dressing, then go to the Casualty Department. A tetanus injection may be needed.

Cystitis

Cystitis is an inflammation inside the bladder. Over half the women in this country suffer from it at some time during their lives, often repeatedly. It makes you want to pass urine frequently and when you do pass water; it causes a burning sensation. When you first get the symptoms, drink a pint of water immediately. A teaspoon of bicarbonate of soda dissolved in the water can relieve some of the pain. Paracetamol tablets are useful. It is important to carry on drinking plenty of fluids to wash the germs out of your bladder. If your symptoms do not settle in a day, bring a specimen in a clean container, as an antibiotic may be required.

Earache

Earache can be caused by excess ear wax, catarrh or infection. If a child gets earache, regular doses of paracetamol medicine eg. Calpol, will ease the discomfort. If the earache does not settle within 12 to 24 hours, consult a doctor.

German Measles (Rubella)

A rash appears during the first day and usually covers the body, arms and legs in small pink patches about 2 to 4mm in diameter. It does not itch. Often no other symptoms are present apart from occasional aching in the joints. It is infectious from two days before the rash appears until four to five days afterwards. The only danger is to unborn babies and it is therefore important that any contacts who might be pregnant are informed so that they can consult their doctor. Immunisation can prevent this disease.

Hay Fever

Hayfever is worse when the pollen count is high. It causes watering, itchy eyes, sneezing and runny noses. Antihistamine tablets or medicine provide effective relief. These can be bought without prescription from your chemist.

Head Injury

If the patient was knocked out and can remember the accident, it is unlikely that serious injury has resulted, but if the patient was knocked unconscious and cannot remember what happened, he or she should be taken to a hospital Casualty Department without delay. If the patient becomes drowsy, or vomits after a head injury, seek advice.

Head Lice

These creatures, contrary to popular belief, prefer clean hair and are therefore not a sign of poor personal hygiene. Medicated head lotions, shampoos and creams are available from chemists without prescription. Treat your whole family at the same time. Special nit combs help to eradicate and identify head lice and regular combing and brushing protects the hair from re-infection.

Immunisation

Soreness at the site of injection and a mild fever for 24 hours afterwards are common and usually settle without any treatment.

Preventing Preventable Diseases

Lung Cancer; stop smoking. Heart Disease; stop smoking, eat sensibly and take regular exercise. Breast Cancer; learn to examine your breasts regularly. Cervical Cancer; do not start sexual activity at an early age, limit the amount of sexual partners, have regular cervical smears at least every five years and stop smoking. Skin Cancer; use correct sunblock to avoid sunburn, keep a careful eye on moles that grow quickly, change colour or shape or those that bleed. Testicular Cancer; learn to examine your testicles regularly. Aids; limit the number of sexual partners, always use a condom - practise safe sex. Family Planning; all the doctors and nurses are approachable for advice on all forms of contraception including post-coital contraception (Morning After Pill). Patients are reminded that Croydon has the highest abortion rates in the UK and this results in local hospitals being swamped, causing delays and many women having to pay for private abortion. Preventing unwanted pregnancies is therefore given priority at the surgery.

Nosebleeds

Nosebleeds in children and young adults are relatively common and usually result from prominent blood vessels in the front portion of the nose that separates the two nostrils. In elderly people, nose bleeds may be due to other cases and may require hospital attention. With a nosebleed, do not panic and do not pull your head back. Whilst sitting on a chair, bend forward with your mouth open. Pinch your nose, firmly pressing the nostrils (from below the bone) against the middle part of the nose for about 10 to 15 minutes. An ice pack or a bag of frozen peas on the bridge of the nose may also help. These measures are usually all that is required. If the nosebleed persists, seek medical advice.

Sprains

Apply an ice pack as soon as a sprain occurs to reduce the swelling. Apply a firm bandage, take painkillers regularly and elevate the affected part. Taking anti-inflammatory tablets as well eg. Nurofen, may help. Rest the part but keep it moving without stressing it. Please note that sprained parts can take up to four to six weeks to return to near normal.

Insect Bites

Most will require no treatment; however, apply antihistamine cream eg. Anthisan cream immediately to reduce the reaction. Taking antihistamine tablets (eg. Piriton) will relieve the symptoms. Both the cream and tablets can be bought from the chemist without prescription.

Thrush

This a common complaint and may affect more than half of all women at some time in their lives. It is caused by a fungus (like mould on bread) that normally lives in the vagina. It usually affects the vagina causing redness, soreness, itching and a creamy white discharge. Common causes of repeated bouts of thrush include overwashing and the use of antiseptics in the bath eg. Dettol. Some women may also get the condition following a course of antibiotics. Any circumstance that makes the vagina less acid allows the fungus to proliferate. Remedies include the use of anti-fungal creams eg. Canesten or pessaries from the chemist, available without prescription.

Allergic Reactions

These are common and occur in people with sensitive skins or those who may be sensitive to certain medicines (eg. penicillin), shellfish, prawns, nuts, certain Chinese meals etc. People who suffer from hay fever, eczema or asthma may be more likely to get a reaction. The rash can affect any part of the body and occur soon after contact with a specific substance. It is usually red, bumpy to touch and very itchy. To relieve the symptoms apply (dab not rub) calamine lotion and take antihistamine tablets eg. Piriton from a chemist. If a medicine prescribed by a doctor causes such a rash, stop taking it and seek further advice.