Dr Anna Hall

28/11/2024

SUMMERTIME IS GASTRO-TIME

Warm weather favours the spread of enteric (gut) viruses. In the Northern Suburbs of Cape Town there has been a notable rise in the number of patients with sudden onset of cramps, nausea, vomiting and diarrhoea.

In most cases this is a self-limiting
condition, but can become severe enough to warrant admission to hospital for intravenous rehydration.

For most adults, fluid replacement, medications for cramps, nausea and diarrhoea are all that is needed. Any accompanying fever or body aches usually responds to regular paracetamol or other similar medications.

Replacing the fluids lost by the vomiting and diarrhoea is the most important point. Remember that these are complex biological fluids, so the replacement fluid should be as close as possible to what has been lost. Fizzy cool drinks are NOT the ideal here. Balanced rehydration solutions to replace the lost minerals and salts are available at pharmacies.

Young children are particularly vulnerable with gastroenteritis, and can very quickly become dehydrated. Don’t delay in seeking medical advice, especially if your child has a persistent fever, refuses his/her feeds or appears drowsy.

21/11/2024

IMPORTANT ALERT!!! – CHECK YOUR YAZ CONTRACEPTIVE?

An alert was broadcast this morning - I cannot verify the content, but rather check than run the risk of unwanted pregnancy.

Manufacturers today announced on radio, a fault in the packaging of a particular batch of Yaz oral contraceptive. There should be 24 pink pills and 4 white (inactive) pills. In a recent batch there were 24 white (inactive) pills and only 4 containing the contraceptive hormone.

If your pack has 24 white pills, it is part of the faulty batch and may mean that you have NO CONTRACEPTIVE COVER for now. Please return any faulty batches to your pharmacy and ask for a substitute pack – which you must open right there and check that there are the correct number of active (pink) pills. Please also note that you will need alternative contraceptive cover until your next period.

If you are in doubt, please consult your doctor Please also advise any of your friends that might be using Yaz to do the same.

18/11/2024

MOVEMBER

Women have their “breast awareness” month in October, and now a pathology laboratory is offering a special service to men for the month of November.

Prostate Specific Antigen (PSA) is a simple blood test that monitors prostate size/enlargement: this test is reliable and is advised for men over the age of 45. This is advised as a baseline for future reference if the man has no prostate related symptoms, and if no new symptoms arise, can be done annually or every 2 years thereafter. But the PSA test can be done at any age if there are significant prostatic symptoms.

This local laboratory is offering the test for R140.00 cash with an extra 5% discount for pensioners.

There are important and relevant facts relating to PSA testing, so please contact your doctor to access this service, and to inform yourself about prostate health.

12/11/2024

YOUR VISIT TO THE DOCTOR

There are different reasons for consulting your doctor – e.g. to find out what the problem is; to get treatment; to learn how to prevent this and other problems recurring; for a regular check-up; to be referred to a specialist etc. An important factor here is what you can do to get the best outcome from the consultation, and you may be surprised at some of the basic things you can do to this end.

1. Be as clear and accurate as you can about what you need help with – when did it start, what was the first thing you noticed, what were you doing at the time, what have you already tried (medication name and dosage) to help the symptoms? Have you recently had another illness or operation?
2. Always disclose any other medical issues you may have – e.g. hypertension, diabetes – and any medication you are using for them. These “background” issues may seem unrelated, but to your doctor they might provide valuable information to help deal with the present problem.
3. Remember to dress appropriately – e.g. if you have a chest complaint, wear a blouse or top that can easily be either unbuttoned or lifted up so that the stethoscope can be placed onto bare skin – stethoscope sounds heard through clothing are totally misleading; If you need a BP reading, wear either a sleeveless top or a garment that lets you take your arm out of the sleeve: a rolled-up sleeve may get so tight that it affects the BP reading.
4. The nature of your work and any details of family illnesses are always relevant.
5. Be prepared to pass a urine sample – samples brought from home may be time-saving, but a “fresh” sample will more likely give accurate test results.

These may seem unimportant but will be a big help towards getting a good outcome for you.

04/11/2024

MANAGE YOUR HEALTH BETTER – SOME TIPS

There are many things you can do “at home” to better manage your health and these are becoming more relevant as medical costs escalate and investigations become more expensive.

The basic advice from all doctors is to quit smoking, exercise moderately, maintain a healthy weight and get enough good quality sleep. Whilst your age, s*x and genetic background cannot be changed, these 4 factors will help get you into optimum condition.

But apart from these basics, there are several things that you can do, especially if you have already been diagnosed with a condition. Here are some tips, starting with MEDICATION.

1. Medication is specific and tailored for your individual needs and circumstances. It is thus risky to “borrow or try out” someone else’s medication, which might be perfect for them, but could be unsuitable – or even dangerous – for you.
2. Prescription medication should be kept in a cool dark place unless it specifically needs to be refrigerated (e.g. insulin).
3. Tablets or capsules should not be removed from their original packaging sheets. The name, dosage and expiry date appear on each sheet so there can be no confusion about which “little white pill” you are taking. Some patients prefer to decant a week’s supply at a time into little plastic pill boxes marked with days of the week: that may save time and one can easily see if a dose has been taken or missed. However, if this is done, the remainder of the month’s supply should be kept in its original packaging.
4. There are specific instructions for taking medication – some on a full stomach or at night or not combined with other medicines. Following these instructions will ensure that you get optimal effects of your medicine.
5. In general, prescribed medication should not be mixed with homeopathic ones as there are some possible unsafe interactions.
6. If you miss a dose, check the package insert for instructions on managing this – this may be very important for those taking contraceptives.
7. Always inform any doctor you consult about which medications you regularly use. It may be easier simply to take a photograph of the boxes with the name and dosage clearly visible. Know the names of your medication -especially if you have recently used an antibiotic and now need another one: this is very relevant in selecting the right medication for you for your current illness.

More tips to come on Medichat….

23/10/2024

MEDSCHEME INNOVATION

If you are a member of Fedhealth, Polmed, Bonitas, Barloworld or other fund administered by Medscheme, this is a useful innovation, one that gives you control over specialist referrals.

Our practice has been selected to trial an app that allows members to easily check benefits and obtain preauthorization for specialist consultations by using their cellphone at our reception – the app is linked to this practice so must be used whilst on the premises. By obtaining preauthorization in this way, you no longer need a formal referral letter from your GP.

You can access this app from our reception by using your smartphone to scan a QR code.

09/10/2024

NEW WEIGHT LOSS DRUGS ??

GLP-1 agonists are injections that help regulate blood glucose, and are one of the many medications used for managing diabetes in patients who have not responded well to the combination of dietary changes plus exercise and other diabetes medications.

These GLP-1 agonists mimic the effects of naturally produced GLP-1, and the best-known side effect is nausea, which in turn leads to food avoidance and therefore to weight loss. Currently, the vast majority of prescriptions are given for weight loss in non-diabetics, and this has led to a nation-wide shortage.

GLP-1 drugs are generally safe but …they are injections given daily or weekly; expensive and not covered by medical aids (yet); weight loss is initially good but weight is usually rapidly regained when the drug is stopped; in animal testing they are associate with an increased risk of thyroid cancer, not yet definitely proven in human use, results still awaited.

If you are very overweight this can lead to metabolic disorders and health risks, so please talk to your doctor about your options.

27/09/2024

THE CHOLESTEROL KILLER

Cholesterol is a naturally occurring substance made by our liver, and – in normal amounts – essential for survival. When overproduction of cholesterol (especially the “bad” LDL kind) is not balanced by the “good” HDL kind, problems can occur. This kind of imbalance is linked to cardiovascular disease such as angina, stroke, heart attack and peripheral vascular disease. It is not the ONLY cause, but is an additional risk factor when there are other risk factors involved, such as smoking, hypertension, diabetes or a family history of cholesterol problems.

As one of the silent killers, raised cholesterol may have no symptoms at all until damage is done. A simple blood test done after an overnight fast, can show not only your total cholesterol, but will also measure the good and bad cholesterol and thus give you an indication of your risk for cholesterol-related heart disease.

About 85% of total cholesterol comes from your liver (genetically programmed), whilst about 15% comes from your diet. This means that although changes in diet will help lower cholesterol, these changes will only affect 15% of the total. If diet changes do not bring your cholesterol down to normal levels, then you’d be a good candidate for medical treatment.

If you have any concerns about your cholesterol, please ask your doctor to request the appropriate test.

27/09/2024

DIABETES – ANOTHER SILENT KILLER

Diabetes is due to a problem with regulating the level of your blood sugar – Blood Glucose (BG) is the form of sugar found in humans and is used as one kind of “fuel” providing energy for the body. Glucose is derived from food – carbohydrates mainly. Excess BG is harmful to all tissues so there are built-in controls to keep the level of BG within a safe range. Ketones (derived from Free Fatty Acids – FFA) are far more effective as an energy source and are not as harmful as is glucose.

Sustained or intermittent high BG damages tissues, and arteries are the first to be hit. Depending on the tissue served by the artery involved, this can lead to stroke, heart attack, blindness, kidney damage or even limb amputation

High BG may be due to dietary factors (the commonest form) or to hormone deficiency (usually detected in childhood). Diabetes starting in adulthood is nearly always linked to excess carbohydrate intake. If detected early in the pre-diabetic stage, it can often be totally reversed by changing diet and making other lifestyle changes. If this does not succeed, there are various medications that can be introduced.

Testing for diabetes is simple – a blood test is done after fasting for about 10 hours. There are further more detailed tests that can be done if this test shows diabetes. Your doctor can arrange for these tests to be done and will advise you on the diet changes you can make to help reverse the condition.

Early-stage diabetes may have no symptoms at all, so it is important to check for this condition before it is advanced and causes permanent organ damage.

19/09/2024

HYPERTENSION – SILENT KILLER #1

The previous post identified high Blood Pressure (BP) as one of the three silent killers. Here are some facts that will help you to better understand the condition.

Hypertension is essentially an increase in the pressure of your arteries – the “pipes” through which your blood circulates as it is distributed to your whole body. Blood pressure is measured using an inflatable cuff placed around the upper arm (not wrist), and there is a specific way of doing this that ensures a correct reading.

The “ideal” blood pressure is 120/80 (measured in mm of mercury), but this can vary with age. The top and bottom numbers represent different things and have different clinical implications.

The higher the blood pressure, the more work the heart has to do to keep blood circulating, and this can lead to heart failure. High blood pressure also increases the risk of heart attack and stroke, and is also linked to kidney failure.

A family history of hypertension, heart attack or stroke puts you at increased risk, so please get your BP measured at your doctor or local pharmacy. If the reading is above normal, please consult your doctor for help. Many factors affect BP : your doctor can help to identify and correct these things, so you may not need medication.
Remember that for any condition, early diagnosis is your best chance of a good outcome, so don’t delay.

15/09/2024

SILENT KILLERS

Whilst South Africa has confirmed a case of Monkeypox and there is much talk of preventing a pandemic, there are three serious conditions here affecting thousands of people. These are known as the “silent killers” because they have no obvious symptoms until the condition is advanced or has caused some organ damage.

These silent killers are high blood pressure, high cholesterol and high blood sugar. If undiagnosed and unmanaged, these can lead to stroke or heart attack (sometimes fatal), blindness, kidney failure, neuropathy and amputations.

You may not know that you have any of these silent killers unless you look for signs of them. If you are overweight and a smoker, or if anyone in your family has any of these conditions, you are at risk of developing them too. To protect yourself, consult your doctor who can do clinical and blood tests to advise you.

08/06/2024

CITY OF CAPE TOWN

7 JUNE 2024

URGENT NOTICE (after 2 rabid dogs found in Cape Town)

City cautions public to stay away from seals due to a confirmed rabies case

The City of Cape Town is advising the public to stay away from seals as far as possible, and with immediate effect.

The Western Cape Provincial Veterinary Services has confirmed this afternoon, 7 June 2024, that a Cape Fur Seal off the coast at Big Bay has tested positive for rabies. This seal died on 22 May 2024 and the laboratory results came in earlier today.

As such, the public must take extra precaution to stay away from Cape Fur Seals as far as possible, and to not, under any circumstances, allow their dogs close to these animals. This precaution applies to the entire Cape Peninsula coastline.

Any person bitten by a seal is urged to seek immediate medical attention, and to notify the relevant authorities. The same applies to any pet bitten by a seal.

The authorities will keep on investigating and keep the public informed.

See the following links for recent media releases with more information about rabies:
· https://www.westerncape.gov.za/news/dog-rabies-confirmed-cape-peninsula
· https://www.capetown.gov.za/Media-and-news/Public%20cautioned%20to%20be%20alert%20following%20confirmed%20dog%20rabies%20case

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