Marys Medicine

Information For Patients
93 st George's road, Cheltenham, Gloucestershire Gl50 3eD
Appointments: (01242) 255337 • Tel: (01242) 519049
fax: (01242) 253556
Urgent out-of-hours service: 0300 4210 220
Surgery Opening Hours
The Surgery Is Open .Monday - Friday 8.00am - 6.30pm Extended Opening Hours .Monday Evening 6.30 - 8.00pm The Telephone Lines Are Open .Monday - Friday 8.00am - 6.30pm Appointments Are Available Between . 8.00am - 11.30am and 2.00 - 8.00pm

Welcome To The Practice Yorkleigh Surgery is one of 19 practices within the Cheltenham area under the Gloucestershire Primary Care Trust (PCT), offering healthcare to 8,744 patients. We have Call us free on 0500 202211
been operating from our current premises for over 25 years.
There's a wealth of knowledge and experience We trust you find this booklet useful, but please let us know if there is anything else you would like to know more about.
at Badham Pharmacy.
We're here to help with your needs and to offer health advice and support.
Dr Isobel McKenzie
You are very welcome to visit our pharmacy for all MB ChB (1983) Dundee, MRCGP DRCOG your dispensing needs or even just for a chat; Dr Andrew Green
MB ChB (1990) Birmingham, DCH we'd be only too pleased to see you.
Dr Mark Malden
MB BS (1990) London, MRCGP • Free prescription collection and delivery service Dr Jane Pringle
MB BCh (1982) Belfast, MRCGP DCH DRCOG • Diagnostic testing Dr Christopher Kinchin BSc MB BS (1976) London, MRCGP
• Specialist service to nursing/residential homes • Private consulting area • Homeopathic and herbal products Monday-Friday 9am-6pm (Closed between 1-2pm) nurse PracTiTioners
Sunday opening available at Church Road, Bishop's Cleeve Jane and Stephanie PracTice nurses
and 6 to 7pm on Sundays Teresa and Debbie (triage and minor illness, wound dressings, immunisations, ear syringing, Telephone: 672653 blood tests, vaccination advice, new patient registrations, blood pressure monitoring, dietary/weight management support, well person checks, clinics for asthma, COPD, 6 Prestbury Road
diabetes and CHD, travel advice, baby immunisations, smoking cessation, smears, young persons' clinics and contraception advice). Telephone: 01242 523226
For 24 hour information contact:
To advertise your business to our patients on low cost, easy payment terms call 0800 0234 196.
healTh care assisTanT
Coral (blood tests, blood pressures, health checks and smoking cessation, dressings and The registration process must be done in person at the practice. A registration form must suture removal). be completed in full or, if you have your registration card from your previous doctor, this can be completed and brought to the practice. Two forms of ID are required for all healTh visiTors
permanent or temporary patients, one of which must be photographic, preferably a Rachel Wayman and Liz Brumwell (Tel: (01242) 513368.
The practice operates a pooled list system where patients are registered with the practice There is a pre-bookable clinic from 1.30 to 2.30pm. Drop-in patients will still be welcome and not with a specific doctor. Should you wish to be seen by a particular doctor then you and seen from 1.30 to 3.30pm.
need to let the receptionist know and your wishes can be recorded on your electronic medical record.
ParkiNg/diSablEd aCCESS
Chrissie and Faye Parking is available at the front of the building, and at the back where there is also (Tel: (01242) 532334, or out of hours (01242) 272151)
disabled access to the back of the building.
Tel: (01242) 519049
Antenatal clinics are held weekly at the surgery by appointment. The midwife can be If you are too ill or frail to get to the surgery and need a visit at home, please ring the contacted directly on 0300 422 2318 at any time.
surgery before 10.30am if possible. The receptionist will ask you for a few details to allow the doctor to assess the urgency of the case. Whenever possible, patients will be encouraged to attend the surgery. This saves the doctor time and therefore allows more patients to The phlebotomist is available for blood tests at the surgery daily by appointment be seen. It is not possible to visit all our patients immediately after hospital discharge and and between 12.40 - 1.25pm for routine blood tests. The phlebotomist is employed by a visit is rarely required after routine surgery. However, if you are still feeling unwell or not Gloucestershire Hospitals NHS Trust with the service financed by the Primary Care Trust.
making satisfactory progress, please let your doctor know. We are an approved practice for medical students to gain experience in general practice. Tel: (01242) 255337 8.00am - 6.30pm
If your doctor has a student with them, the receptionist and doctor will inform you. You The surgery operates a telephone triage system, conducted by the duty doctor or a will be given the opportunity to see the doctor alone if you wish.
trained practice nurse, to deal with urgent, same-day appointments or home visit requests. HOw TO aCCESS THE PraCTiCE
When a patient phones in these circumstances, they will be asked by the receptionist for a phone number and a brief description of the problem. The latter does not have The surgery is open Monday to Friday 8.00am - 6.30pm. to be given but would help the doctor or nurse to prioritise the call. We endeavour to When telephone lines are busy an automatic attendant will be activated and you will contact all patients within an hour. If the problem is life-threatening, the call will be put be asked to hold until an operator is available. straight through to the triaging doctor or nurse.
The caller may be offered advice over the telephone, an appointment that day, a home The surgery is closed for one afternoon every three months for staff training. The usual visit, or a routine appointment later in the week. In more serious cases, the doctor will visit out-of-hours cover is in place during these afternoons.
immediately or arrange for an ambulance to call.
The nurses are trained in triage procedures and also deal with minor illnesses. When offered an appointment, this may be with either a doctor or nurse (you will be informed at the time). Tel: (01242) 255337 8.00am - 6.30pm
If you have a preference either way, please let us know; we will try to accommodate you.
Appointments may be made in person or by telephone. Please make a separate OUT Of HOUrS
appointment for each person. If you cannot attend please cancel as soon as possible. Urgent cases will be seen as soon as possible. Please be considerate if someone else The out-of-hours service covers the telephone lines between 6.30pm and 8.00am on needs to be given priority.
weekdays, all through weekends and public holidays. If you need urgent medical treatment 'out of hours' that cannot wait until the GP surgery re-opens, you only need In order to make the best use of practice staff time and resources it is very important that to ring one number for help - 111.
our patients attend their booked appointments, or let us know in plenty of time if they This number will be answered by specially trained staff who will advise you accordingly. are not able to attend so that we can allocate that appointment time to someone else. This service is provided by Gloucestershire Primary Care Trust. For 24 hour information contact:
Visit our website on:
You can contact NHS Direct or visit NHS Direct Online for health advice 24 hours a day. WhaT is cQc – care QualiTy coMMission?
Tel: 0845 4647 Web:
CQC is the Governments' independent regulator of all health and social care services in England. Their job is to make sure that care provided by hospitals, GP surgeries, dentists, ambulances and care homes, together with a variety of other services, including services TEST rESUlTS
in people's own homes and elsewhere, meet national standards of quality and safety.
It ensures that essential standards of care are being met and taking action when not.
Please telephone (01242) 519049 between 12 noon and 4.00pm for results.
Do not assume the practice will contact you with an abnormal result. It is a requirement
of employment that the confidentiality of patients' records is maintained at the highest
WhaT are The naTional sTandards?
level by all staff.
The national standards cover all aspects of care, including:-Treating people with dignity and respect.
Making sure food and drink meets people's needs.
Making sure that the environment is clean and safe.
Managing premises and staffing services.
Fax: (01242) 253556
Repeat prescriptions should be requested either in person, in writing or by fax. Email is via
our website Repeat medications will have been arranged
by your doctor and entered onto your computer record. With your prescription you will CQC inspectors visit health and adult social care services across England to check that also receive a repeat order form. When you require further medication you should tick they are meeting the national standards. They make unannounced inspections of services the items required on the form and return it to the surgery. Please allow two working days on a regular basis, and will visit at any time in response to concerns. for prescriptions to be processed. During practice training days and over bank holidays this time may vary slightly. If you wish to receive your prescription by post, please include Ask people about their experience of receiving care.
a stamped, addressed envelope and allow extra time for it to reach you.
Talk to staff.
Please do not order your medication until you have no more than a 10-day supply left. Requests for early medication will be queried. For example, are you going on holiday? Check that the right systems and processes are in place.
Have you lost some medication? Does the pharmacy owe you some pills? We will try Look for evidence that care is not meeting the national standard.
and contact you so please make sure your contact details are up to date.
PleASe nOTe: Prescriptions received before 12 noon will be ready for collection after
hoW cQc enForces sTandards
2.30pm in two working days – Monday to Friday.
When standards are not being met, they can use their powers to:- Repeat prescriptions should be requested either in person, in writing or by fax. Email is via our website Issue fines or warnings.
We do not accept requests for prescriptions over the telephone.
Stop admissions into a care service.
Suspend or cancel a care service's registration.
For more information about the CQC visit their website COMMENTS, CONCErNS aNd SUggESTiONS
Comments, complaints and suggestions are a good way for us to learn about how to improve our service. If you have reason to make a complaint, comment or make a suggestion about our services, please write to Mrs Caroline Cole (Practice ExPErT PaTiENT PrOgraMME
Manager). Your comments will be treated in confidence. If you have an issue you If you have a chronic condition (or are living with someone with a long-term health cannot discuss with the practice, you can call the Community Patient Advice and condition) ask your GP about the Expert Patient Programme. It is a self-management Liaison Service (PALS). This service can help you with advice, information and support. programme designed to give patients additional skills to help them to manage their Call: 08000 151 548/0845 658 3888.
own condition eg exercise and diet advice, problem solving, getting the most out of We are keen to involve local people in shaping local health services. If you would like your visit to the GP or hospital. The six-week (two hours a week) course is free and is run to get involved why not visit: involved or ask the
by patients themselves. receptionist for a 'Get Involved' booklet. For 24 hour information contact:
Visit our website on:

My name is Dan Fivey and I run The Gym Cheltenham and a private rehabilitation-training studio. In both locations you will find equipment you may not have seen before, such as Staff treating patients have a right to work free from any form of threat, fear, abuse the ‘Aerofloor' and the AlterG anti-gravity treadmill: these are or violence. The GP practices in Gloucestershire have agreed a Zero Tolerance Policy. specialized equipment unique to Gloucestershire. Depending on the gravity of the incident, a patient who is verbally rude or mildly abusive I have now been using the Alter-G Treadmill for over two may be given a 'Yellow Card' as a final warning. Any further incident will result in a 'Red years and have had some wonderful success stories from Card' with the patient being removed from the practice list. clients who can't say enough about how good it feels to be able to walk or run again. We have used it successfully in post- Following a 'Red Card', the patient may face police charges resulting from the incident surgery rehabilitation. It gives my elderly clients a chance to ADVER and will not be seen by any local GP practice. The patient will have to travel to Gloucester maintain their aerobic fitness and we've had patients that to the Vaughan Centre to receive any further GP services in a secure environment and have had a stroke who are working on improving their gait. TISING FEA will not receive home visits. People with chronic pain are running without pain and clients too overweight and under-confident to participate in regular No mirrors, No loud music,
exercise are now managing vital Cardiovascular exercise No loNg coNtracts
lOOkiNg afTEr yOUr HEalTH -
with less strain on their joints. There are many more people TURE Exercise machines, Boxing, Physio,
the Alter-G could benefit which is why I wanted to make 10 STEPS TO a HEalTHiEr lifESTylE
Nutrition advice, running classes,
you aware that there is one available in Gloucestershire that Kids Fitness, Weights, Kettlebells,
• Eat five portions of fruit or vegetables every day your friends could access. I currently look after MS patients, Massage, Reflexology, Personal Trainers, diabetics, post surgery, amputees, elderly, stroke rehab,
• Cut down on the amount of fried food you eat sweat towels, Fruit after Every Visit
cerebral palsy children, overweight and injured sports players.
• Try and keep within the ideal weight range for your height All clients are supervised by highly qualified Personal MEMBERSHIPS FROM 12 YEARS
• Drink more water and less sugary drinks Trainers or Physiotherapists and we pride ourselves on OLD FROM £15 PER MONTH
providing a safe, non-intimidating environment for clients to • Drink no more than one or two units of alcohol a day reach rehabilitation or fitness and health goals. If you feel you • If you smoke, try to cut down or think about giving up have any friends who would benefit from the Alter-G or any Telephone: 07709 169997
other equipment we have, or you have any questions at all, • Take a brisk walk every day please phone or email me and I will be happy to talk to you.
• Keep out of the midday sun What is Shiatsu?
• Set aside a time for relaxation• Make sure you get enough sleep to see you through the day Shiatsu is a traditional Japanese therapy that is tailor-made for you. The aim is to produce an overall amazing sense of wellbeing, with a meditative-like relaxation to promote wHaT TO dO iN aN EMErgENCy
good-health with regular body maintenance. CAll An AMBUlAnCe
Shiatsu simply means finger pressure, but the holding techniques used are appropriate for your condition, and do noT Move The PaTienT iF
Shiatsu can ease a variety of ailments. Pressure is applied • You think there may be a back or neck injury or any other injury that could be made to the areas of the body, comfortable to the touch, with worse by movement TURE an emphasis on your body's natural energies, using acupressure points. • The person is in shock Shiatsu is a holistic treatment; you the receiver will be • The person has breathing problems treated as a whole, whilst taking into consideration why • The person has severe chest pains you have visited. Shiatsu is excellent for promoting a deep relaxation, can enhance your mood, relieve tension and iF The PaTienT is noT seriously ill or inJured
ADVER aid sleep; which in turn can restore good health.
• Take the patient directly to the accident department of the nearest hospital Whatever the treatment is that you receive, it is fully clothed, and done with the utmost care of your comfort When To seek urgenT Medical aTTenTion
and consideration for your situation.
• Head injuries A Shiatsu is designed for your needs on that day - no two • Loss of consciousness treatments will ever be the same. a truly personal and in • Severe bleeding, chest or stomach pains the moment experience.
• Broken or dislocated bones Please check for the CNHC mark when booking to ensure a qualified practitioner.
Visit our website on:
Attract more business by placing your advert here. simply call 0800 0234 196.

gerMan Measles (ruBella)
If the patient is unconscious but breathing The rash appears during the first day and usually covers the body, arms and legs in small • Turn them on their side pink patches about 2-4mm across and doesn't itch. No other symptoms are usually present apart from occasional aching joints. It is infectious from two days before the • Check airway is open by lifting their chin and tilting the head back slightly rash appears, until the rash disappears in about four or five days from that date. The only hoW To recognise severe chesT Pain or a hearT aTTack
danger is to unborn babies and therefore it is important that all contacts are informed • Vice-like pain in the middle of the chest, often spreading down the left arm and jaw in order that anyone who may be pregnant can contact their doctor.
• Shortness of breath immunisation can prevent this disease
• Sudden faintness or giddiness • Grey pallor to the skin The rash is blotchy and red and appears on the face and body around the fourth day • Lips look blue of illness. It is at its most infectious from two or three days before the rash appears until eight to ten days after that date.
WhaT To do iF The Pain does noT ease
immunisation can prevent this disease
• Make the patient comfortable This is a rare illness that is most common in babies, children under four years and teenagers, hoW To recognise Medical shock
and requires urgent attention. It is important to be aware of the symptoms which we have listed below.
• Patient becomes pale, sweaty, drowsy and confused Signs and symptoms in BABIES and VERY YOUNG CHILDREN are: • Difficulty waking • Seek urgent medical help • A high pitched cry that is different from a normal cry • Reassure the patient • Repeated vomiting • Do not give anything to eat or drink • Refusing feeds• Pale or blotchy skin, especially with red or blue/black bruises that don't go white when iF unconscious BuT BreaThing
you press on them • Place in recovery position as shown here • Tight or bulging soft spot on the top of your baby's head
if you are in any doubt contact your doctor immediately.
ViSiTiNg yOUr CHirOPraCTOr
Signs and symptoms in OLDER CHILDREN and ADULTS are: Treatment consists of well defined manipulation techniques which are aimed to improve • A high temperature joint pain and muscle spasms. Chiropractic is currently the second most frequently • A constant headache consulted complementary therapy.
The Medical Research Council have found that chiropractic is more effective than • Drowsiness or confusion hospital outpatient treatment for lower back pain. Chiropractic treatment is particularly favoured for easing back pain, sciatica, tension, neck, shoulder and arm pain.
• Dislike of bright lights• Stiffness of the neck (moving their chin to the chest will be particularly painful) CHildHOOd ailMENTS
• A rash of red/blue spots or bruises that don't go white when pressed with a tumbler
if you are in any doubt contact your doctor immediately.
On the first day a rash appears as small red patches about 3-4mm across. Within a few
hours, small blisters appear in the centre of these patches. During the next three or four Symptoms are swelling of the gland in front of one ear often followed, after a couple of days further patches will appear and the earlier ones will turn 'crusty' and fall off. Calamine days, by swelling in front of the other ear.
lotion may be applied to soothe the often severe itching. Cool baths may also help.
• It is infectious from two or three days before the swelling appears until eight to ten The most infectious period is from two or three days before the rash appears and up to days after that date five days after this date. Children may return to school as soon as the last 'crusts' have • If the pain is severe you should consult your doctor immunisation can prevent this disease
For 24 hour information contact:
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Would a Care/Nursing Home Provide the Solution?
One part of life's rich tapestry is that things are constantly changing. Perhaps one of the more difficult things to cope with is admitting that we, or our loved ones, are growing older and are, perhaps, finding it difficult to cope with living alone. At such times thoughts turn to residential care. This is a big decision so it's very important to make the right choice.
Until recently there were two distinct types of home available - Nursing Homes and Care Homes (often referred to as Rest Homes or Retirement Homes). The title means very little but ADVERthe type of care available varies considerably from home to home. The aim in all cases is to ensure that care is flexible and tailored according to the needs of the individual.
Some homes now cater for both nursing and residential care. This means avoiding the trauma of having to move again if the patient's health deteriorates and nursing care becomes necessary. Normally, in either case, there is a programme of activities available to all residents who wish to take part. The objective in most homes is to encourage residents to retain their interests and enjoy life in general as much as they can.
The quality of accommodation and care can vary significantly between homes and exploring the various options may be difficult. So arrange a visit and ask your questions personally. Treat your visit as if you were buying a house and trust your feelings and instincts. The choice is YOURS – it is your right to choose! Dance YOUR way to better Health
The Government recommends that everyone takes part in Patricia NewmaN
30 minutes of moderately intense physical activity five times a week. That's activity that gets you breathing faster, increases your heart rate and warms you up. Dancing is largely an aerobic activity that improves the condition of the heart and lungs, as well as tests your balance. To dance also requires muscular endurance, stamina and a level of fitness. So the good news is that dancing counts.
Most dance styles, even a stately waltz, have an activity rating equivalent to at least a moderate (3mph) walk. Anyone dancing will increase their heart rate, warm up and breathe faster. Regular dancing can reduce the risk We are a well respected school offering a range of classes of cardiovascular disease, high blood pressure, type 2 in ballet, tap and modern for all ages and abilities. diabetes and cancer. What is more, the dips, turns and Private lessons are also available for adults and children.
side-to-side movements in dance routines make good We encourage pupils to improve their dance skills, use of your muscles and joints, helping to delay the developing personality and musicality, building confidence progression of any osteoarthritis. And added to all these and nurturing a love of dance with emphasis on enjoyment. benefits you will get out, meet new friends and generally Every child has the opportunity to enter have so much fun you'll forget you are exercising.
examinations or take part in festivals.
Whatever your age dancing is an excellent and enjoyable School holiday activities are also available.
form of exercise. So go along to your local Dance School Free trial lesson on production of this advert
and ask about the wide range of classes available. Whether you are an absolute beginner or a budding ‘Fred' or Darley house, carlton Street, cheltenham gl52 6ag ‘Ginger', there will be a dance class to suit YOU. Why 01242 512301 or 07812 537809
not go along, improve the rhythm of your life and Dance [email protected] YOUR way to better health! To advertise your business to our patients on low cost, easy payment terms call 0800 0234 196.
Attract more business by placing your advert here. simply call 0800 0234 196.
hoW To look aFTer a child WiTh a TeMPeraTure
There are two types of coughs, chesty and dry. A chesty cough has phlegm on the chest, A child will develop a fever because of an infection. Usually the child will get over such a dry cough does not. Until you are certain which type of cough to treat, simple linctus an infection without the need for antibiotics. That's because most childhood infections can be used for both types of cough. Dry coughs can be treated with cough suppressants are caused by viruses and these do not respond to antibiotics. The following advice will or antitussives which stop the urge to cough. Pholcodine is one such recommended help to bring your child's temperature down and make them feel better. linctus. Productive coughs should be actively encouraged to aid removal of phlegm Always keep a supply of paracetamol syrup (Calpol, Disprol) at home. If you wait until from the chest. Glycerine, honey and lemon are soothing. Other additional remedies you need it, there will be none close at hand. can also help break up the phlegm, eg steam inhalations with menthyl or Olbas Oil, taking a hot bath or shower, and using a vapouriser at night.
If your child feels hot or appears unwell:• Give the maximum dose of paracetamol stated for a child of that age. • Dress your child in cool clothes. A lot of heat is lost through a child's head, so leave it uncovered. Cool down the room by opening doors and windows. It's easy to take your health for granted. By following a healthy lifestyle you can reduce the • Give your child plenty of cool drinks as fluid is lost with a fever. If they are reluctant to risk of getting seriously ill. You will feel better and it will help improve your immune system.
drink, encourage small amounts from a favourite cup. • Sponging your child down with a tepid flannel will make them feel better as well as bringing their temperature down. Using tepid water is more effective than using cold water. • Repeat the dose of paracetamol every four hours as necessary, up to the maximum Consumed in moderation, alcohol is acceptable, and in small quantities, alcohol can daily dose stated. actually be benefical to health. In large quantities, on a regular basis, it can have a very • A child with a fever is likely to be restless at night. Offer cool drinks and sponge them serious negative effect on health.
down if they wake. • If your child does not improve after giving paracetamol and sponging, or appears • An accepted safe limit is 21 units a week for men and 14 units for women, a unit being particularly ill, call the doctor. approximately a small glass of wine, half a pint of beer or a single measure of spirit • Very rarely, a child under five years will have a convulsion with a high temperature. • This recommended maximum presumes that the consumption is spread throughout the week and not consumed all at once in a 'binge' They will shake all over and become very still. It usually subsides in less than five minutes. Lie the child on their side and stay with them while it lasts. If there is another adult in the house, ask them to phone a doctor. If not, call when the convulsion has passed.
• Lung cancer is the second most commonly diagnosed cancer in the UK and causes SElf TrEaTMENT Of COMMON ailMENTS
more than a fifth of all deaths from cancers• Over 100,000 people die each year in the UK from smoking-related diseases Many common aches and pains can be treated simply at home without the need to consult a doctor.
hoW To give uP
colds and Flu
Stopping smoking is all about motivation. Without the real desire to give up you will be Colds and influenza are both caused by viruses transmitted through the air. They unable to succeed. You must want to give up rather than feel you should give up.
both have common symptoms, but are not similar. Unlike a common cold, flu can be • Set a date a week or so in the future when you intend to stop dangerous. Both symptoms are treated the same, and neither can be treated with antibiotics.
• Tell all your friends, relations and work colleagues that you're giving up on that day For the common cold the symptoms of headache, runny/blocked nose, runny eyes, and ask for their support and encouragement. If at all possible, find someone to give slight fever and dry cough can be alleviated by taking regular aspirin or paracetamol, decongestants and cough suppressants along with plenty of fluids and rest. A cold • When the big day comes, plan it carefully with plenty to keep you occupied. Avoid will last 7-10 days, while influenza has additional symptoms of fever (high temperature) situations where the desire to smoke will be strongest such as whilst drinking lethargy, sweating, joint aches and pains which can last over two weeks. If you are elderly or have a chronic health problem (eg heart disease, chest disease or diabetes) • Finally, carefully put the money you would have spent on cigarettes on one side, each we would recommend an annual flu jab.
day, to save up for some special treat as a reward If you've tried everything and failed but are still keen to give up, seek help from your doctor or practice nurse. For 24 hour information contact:
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A balanced diet combined with regular exercise will help maintain a healthy body. The Food Standards Agency provides eight tips for eating well: • Travel sickness tablets 1. Eat lots of fruit and vegetables 2. Base your meals on starchy foods • Rehydration solutions such as Dioralyte • Anti-diarrhoeal, eg Imodium 4. Cut down on saturated fat and sugars • High factor sunscreen; calamine lotion 5. Try to eat less salt, no more than 6 grams daily 6. Get active and try to maintain a healthy weight • Always check whether you need any immunisations or malarial tablets before you 7. Drink plenty of water 8. Don't skip breakfast (it can make you gain weight if you do) • Seek advice well in advance in case you need a course of injections oTher essenTials To Pack
EigHT wayS TO kEEP HEalTHy
• Anti-malarials • Water purification tablets Has yours been checked in the past five years? • Insect repellent • Condoms/other contraceptives Some people are overweight - others are 'undertall'! Chances are you weigh more than you should. • Arrange medical insurance More and more people are giving up smoking. There are various programmes available • Obtain a form from the Post Office to apply for a European Health Insurance Card to help you give up. or apply online at if you are travelling in Europe. This will entitle you to free or reduced cost medical care within the EU. Take the card with you on holiday. (Care can still be very expensive even with an EHIC card.) Regular exercise has both physical and mental benefits. MUSClE aNd JOiNT PaiN
Tension and anxiety can be helped by a psychologist or counsellor. Pain in muscles and joints are common and seldom need to be treated by a doctor. Consumed in moderation, alcohol is acceptable. WhaT To look For
• Stiffness and pain especially with movement We recommend women should have regular three-yearly cervical smears. • Strain due to overexertion We will check if you are immune and bring your cover up to date.
• Injury• Inflammation HOliday HEalTH
• Wear and tear It is always a wise precaution to pack some essential items in case of illnesss on holiday.
TreaTMenT aT hoMe For Muscle Pain
• Massage affected part and keep it warm
Do choose medicines according to your needs and the country you are visiting.
If you take prescription medicines regularly remember to pack them too. • Take painkillers such as paracetamol or ibuprofen For 24 hour information contact:
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TreaTMenT aT hoMe For JoinT Pain
• Rest the sore joint There's a big difference between caring about a loved-one and caring for them.
• Take painkillers as for muscle pain Many of us experience the joys (and the occasional frustrations!) of being in a Family sharing our lives with Spouses, Partners, Children, Parents and other relatives. However this can all change if we find someone becoming dependent on us because of sTrains and sPrains
long-term physical or mental illness or disability. Such a circumstance can cause us emotional, physical and perhaps financial stress.
Rest the injured part
It is estimated that as many as 1 in 8 adults, and many young people too**, are Carers in this way - some becoming overwhelmed by the experience. If this is you please have Ice wrapped in a cloth - or a bag of frozen peas - can be used to reduce the swelling
a look at the websites below.
Compress the injury gently with a bandage
**A young carer is anyone under 18, whose life is in some way restricted because of the elevate the injured part
need to take responsibility for the care of someone who is ill, has a disability, is experiencing mental distress or is affected by substance misuse.
When To see your docTor
availaBle To carers aT yorkleigh
• If the pain in the joint or muscle does not improve after three days ‘Flu jabs for carers – please contact the surgery for further information Join the Patient Participation Group.
• If the joint looks deformed As a registered Carer if you fall ill, you will be given priority treatment, we may not know • If there is swelling that you are a carer so please make sure you tell us when you call for an appointment. Do you care for someone with Alzheimer's or dementia? Tell us – we need to know! • If mobility is badly affected From July 2013 we instigated a new service for Carer's. Every two months we will phone you to see how things are, life for a carer can change rapidly and you may not think to update us or may not have the time.
PrEPariNg fOr PrEgNaNCy
USEfUl wEbSiTES fOr CarErS
If you are planning to start a family you must, of course, cease contraception. If you gloucesTershire young carers
are taking the pill you should change to a barrier method for a period of at least three months. This is to allow for the normal hormone levels and egg production cycle to Supporting the ‘young' in young carer. re-establish itself. If you smoke, both you and your partner should stop. A woman who smokes during Working to enhance the lives of Carers. pregnancy stands a 30% greater risk of miscarrying or losing the baby at birth due to a gloucesTershire ParenT carers
variety of complications. You should also ensure that your alcohol consumption is kept to an absolute minimum if you are unable to abstain totally. An organisation set up to ‘knit-together' the various strands involved in caring for a child with particular health needs. Both partners should give attention to their diet with particular regard to choosing fresh unrefined foods. Ask your doctor to check if you are immune from rubella (German measles); if not, he will arrange immunisation. In such a case you should continue with Care and support. Your essential guide to social care. a barrier method of birth control for a period of at least two months whilst the vaccine takes effect. Unless you've had one during recent months it is advisable to arrange for a carer's eMergency scheMe
smear test to ensure you have a healthy cervix prior to becoming pregnant. Urgent help for ill or incapacitated carers. ProBleMs in conceiving
PosiTive caring PrograMMe
One in ten couples experiences some degree of difficulty in conceiving. This difficulty ‘Positive Caring' is a series of free sessions, held all over the County, designed to give Carers may equally be caused by a problem concerning either partner. The causes of infertility the chance to gain confidence in looking after themselves and the person they care for. are wide and varied but most can be helped with treatment. Good pre-conceptual care will lessen the need for such treatment.
carers uk
The voice of carers.
For 24 hour information contact:
Visit our website on:
With the NHS nowadays, there are lots of choices. By making the right choice at the right You need to apply in writing to view your records and an appointment will be sent to you. time, you get the best possible treatment.
During the viewing you will be accompanied by a member of staff should any questions need to be answered or any data entries clarified. There is a charge for this service and have you Tried your PharMacisT or cheMisT?
an additional charge is made for any photocopying. Pharmacists are qualified to give advice on common complaints, such as coughs, colds, flu, sore throats, aches and pains. They can also answer any questions about medicines frEEdOM Of iNfOrMaTiON aCT
and other issues, such as healthy eating and giving up smoking. Your pharmacist can advise you when your symptoms are more serious and may suggest you visit your GP. The purpose of the Act is to give everyone greater rights of access to information about how public authorities work. Gloucestershire PCT has produced a publication scheme have you called nhs direcT?
of all documents available to the public on its website at:
NHS Direct is a confidential 24-hour advice and health information service staffed by For more information about the Freedom of Information Act visit:
nurses and professional advisers. You can call NHS Direct on 0845 4647, any time, for
immediate advice on what to do if you or a family member feels ill. NHS Direct also
provides information on particular health conditions; self-help or support organisations; and local health services. For those whose preferred language is not English, there is the Here is a list of useful medicines and dressings with a description of their uses. All are quite choice of a confidential translation service. For patients' safety, all calls are recorded. cheap and worth stocking at home in readiness for minor illnesses. Calls are charged at local rates.
Keep them in a box or cupboard with a lock - or store them well out of the reach of children. do you need To visiT your gP surgery?
Your local GP surgery provides a range of services, including general medical advice
soluBle asPirin TaBleTs
and treatment; prescriptions; referral to a specialist or hospital (where appropriate); Good for headaches, colds, sore throats (gargle with the solution), and pains in general. Aspirin should NOT be given to children under 16. jabs and tests (such as immunisations, blood tests or cervical smears). Remember to tell your doctor if you have tried or are still taking any self-care treatment. For most medical problems arising within normal surgery hours, you can phone your surgery to make an For relief of pain or fever in young children. appointment with your GP or practice nurse. If your surgery is closed and you need sedaTive cough lincTus
urgent treatment, call NHS Direct for advice, or phone your GP surgery and follow the For dry or painful coughs - but not coughs caused by common colds. recorded instructions. do you need eMergency hosPiTal TreaTMenT?
Add to hot water to make steam inhalations for treating catarrh and dry or painful coughs. If so, you should make your own way to your nearest accident and emergency (A&E) department or call 999 for an emergency ambulance. An emergency is a critical or life Again, for steam inhalations. Also useful for children with stuffy noses or dry coughs. Rub threatening situation which may include loss of consciousness, severe chest pain or loss on the chest and nose. of blood. Remember to keep calm, do everything you can to help the person, but don't put yourself in danger and don't give the person anything to eat, drink or smoke. Please ePhedrine nose droPs
remember that hospital accident and emergency departments are designed to treat For runny noses in children over one year old. Use before meals and at night but not for accidents and emergencies only. more than four days. do you need an aMBulance?
anTisePTic soluTion
One teaspoon diluted in warm water for cleaning cuts and grazes.
People are all familiar with the 999 phone number to call an ambulance, but when is it right to ring? The service is for emergencies, when an immediate response is vital. As soon as your call is received, an emergency ambulance is sent to your location. Situations For treating septic spots, sores in the nose and grazes. requiring this service include: • Serious accidents • Unexplained collapse or if unconscious For dabbing (not rubbing) on insect bites, stings and sunburn. • Breathing problems For 24 hour information contact:
Visit our website on:
3" Wide crePe Bandage
To keep dressings in place. To support sprained or bruised joints. coTTon Wool
For cleaning cuts and grazes.
For fevers.
For removing splinters.
Remember that your local chemist can give you advice about medicines.
gloucesTershire care services nhs TrusT
Gloucestershire Care Services NHS Trust, Edward Jenner Court,1010 Pioneer Avenue,
Gloucester Business Park, Brockworth Gloucester Gloucestershire GL3 4AW
Email: [email protected] Tel: 0300 421 8100
Gloucestershire Hospitals NHS Trust - Tel: 03004 22 22 22
Gloucestershire Partnership Trust (Mental Health and Learning Disabilities Service) -
Tel: (01452) 891000
Guide (Health, Social Care and Disability Information Service) - Tel: (01452) 331131
fiNdiNg a dENTiST
If you need to find a dentist in your local area, you can call the Gloucestershire Dental
Helpline on (01452) 318858 or call NHS Direct on 0845 46 47.
Neighbourhood Direct Ltd A MEMBER OF THE OLDROYD
Keenans Mill, Lord Street, St Annes-on-Sea, Lancs FY8 2ER
Tel: 01253 722142 Fax: 01253 714020
Website: Email: [email protected]
COPYRIGHT WARNING: All rights reserved. No part of this publication may be copied or reproduced, stored in a retrieval system or transmitted in any form or by any means electronic, mechanical, photocopy, recording or otherwise without the prior written permission of the publisher.
The practice would like to thank the various advertisers who have helped to produce this booklet. However, it must be pointed
out that the accuracy of any statements cannot be warranted, nor any products or services advertised, be guaranteed or endorsed.
For 24 hour information contact:
UsefUl Telephone nUmbers
AIDs Counselling & Testing service . 0845 422 6965
Alcoholics Counselling & Information service .584881
Alcoholics Anonymous . 01452 418515
Cheltenham General hospital . 0300 4 222222
Citizens Advice bureau .01242 522491
Dial A ride .01452 502100
Dental helpline .01452 318858
Gingerbread Group (single parents) .0800 018 5026
Gloucester royal hospital . 0300 4 222222
Glos Association for mental health .01452 416575
Grapevine (Advice for Young people) .01242 255888
police station .0845 090 1234
rape Crisis line (Gloucester) .01452 526770
red Cross .01242 523512
relATe (Guidance for relationships) .01242 523512
st John Ambulance .0845 090 1234
samaritans . 0845 790 9090
Victim support .01242 577476
Voluntary Car service .01242 515388
Women's refuge . 020 8995 4430

The prACTICe AreA
Practice Booklets are published by Neighbourhood Direct Ltd. 01253 722142


Modelling effective antiretroviral therapy that inhibits HIVproduction in the liver.Hasifa Nampala1,∗, Livingstone S. Luboobi1, Joseph Y.T. Mugisha1, Celestino Obua3, MatyldaJab lo´ nska2, Matti Heili¨ 1 Department of Mathematics, Makerere University, Kampala, Uganda2 Department of Mathematics and Physics, Lappeenranta University of Technology,Lappeenranta, Finland3 Department of Pharmacology and Therapeutics, Makerere University, Kampala, Uganda∗ E-mail: Corresponding [email protected]

Medicina felina.indb

• Patrón estereotípico (es decir, las convulsiones Tipos de convulsiones son bastante similares porque siguen el mismo • Presencia de actividad motora involuntaria. • Las convulsiones están causadas por una actividad eléctrica anormal en el prosen- • Capacidad mental y comportamiento anor- céfalo y se caracterizan por un episodio males con pérdida de conciencia.