Do I need
antibiotics for this cough?
Post infectious bronchitis is common and adults who are
usually fit and healthy, without underlying disease affecting the
lungs, will, on average, cough for 4 weeks after an upper
respiratory tract infection (i.e. something that starts as a cold
with a runny nose before triggering off the cough). By this stage
any fever symptoms should have settled although the cough can be
distressing and tiring, particularly if it keeps you awake at
night. There is no benefit in taking antibiotics for this problem,
some people's cough will settle sooner and for some it will last
a bit longer than a month. Elderly patients, those with lung
diseases and those with compromised immunity due to disease or
drugs require different advice and should come and see us if they
are unwell.
I have had this
cold for a month
A snotty nose after a common cold infection is not uncommon
and will settle without treatment. If you have pain in the eyes,
teeth and cheeks then you may have sinusitis and may find
decongestant nasal drops or spray effective in relieving symptoms.
These are available over the counter without prescription at the
pharmacy. Ephedrine drops are the safest. You should not use them
for more than 1 week as prolonged use leads to sensitivity
causing a rebound congestion of the nose when you stop the drops.
Patients with untreated high blood pressure should not use
them as they can elevate blood pressure further and they are
dangerous to use with some anti-depressants called monoamine-oxidase
inhibitors (MAOIs e.g. tranylcypromine, phenelzine, isocarboxazid
and moclobemide, check with the pharmacist if you are not sure).
My
baby keeps getting infections does he have a problem with his
immune system?
Find out if your baby is growing and developing normally by
bringing him to the baby clinic to be weighed and checking in
your red book about the stages of development that you should be
expecting to see. If he/she is growing normally then this makes
it much less likely that there is a serious problem.
Babies are as susceptible to viral infections as other people
and this does not imply a problem with their immune system. If
someone in the family brings home a cold/cough then there is
every chance your baby will catch it too. Coughs and colds are
spread by respiratory droplets and are more common in the winter.
Most babies will fight off these infections just like older
children and adults and using paracetamol for pain and
temperature control can be useful. If their nose is bunged up
with thick catarrh making feeding difficult loosening this up
with Normal Saline drops can help.
My baby cries all the
time?
Crying babies can be very distressing and worrying for parents.
If your baby is growing and developing normally then that is
reassuring but be aware that unusual crying, particularly if your
baby is also unwell in other ways (for example, floppy, drowsy,
vomiting, off their feeds, running a high temperature, rash) can
be a sign of illness that needs attention.
Infantile colic is common in babies up to the age of three
months, particularly after feeds when it can be difficult to find
a position in which the baby is comfortable. Try carrying him/her
with their chest in your hand, their tummy along your forearm and
their legs draped either side of your elbow. Stroke their back
and pat their bottom. Some babies are more comfortable draped
over your shoulder. Count down the days until they are three
months old; colic does not go on for ever but if you feel that
you are tired, low, under pressure and feel stressed come and
talk to us.
Baby Snuffles
These are often caused by common cold viruses. Find out if
someone in your family or one of the baby's child minders (or the
children at their house) has a cold. If your baby is generally
well and feeding normally you may wish to treat with paracetamol
for fever and use Normal Saline drops for catarrh (both available
from the pharmacy without prescription). Saline drops (one in
each nostril four times daily) will loosen up any thick catarrh
and help your baby breath more easily, particularly when taking
feeds. Because infants are vulnerable we are always happy to see
your baby the same day if you are worried or feel that something
is not right.
Fever control
in children and adults
We usually advocate alternating ibuprofen and paracetamol
every 3 hours(6 hours for each one) in children, and ibuprofen/aspirin
and paracetamol for adults. Check the doses on the bottle.
Paracetamol is the safest providing the dosage is kept within
recommended limits. Aspirin must not be given to children and
ibuprofen, although generally safe, can cause indigestion, asthma
and upset kidney function in susceptible people. Aspirin tends to
have the same side effects as ibuprofen but is more likely to be
poorly tolerated.
Use of antibiotics
for earache
There is good evidence that most children with earache caused
by infection will settle with pain relief treatment only. This
does not lead to prolonged illness or complications and for most
children we would recommend using just paracetamol and/or
ibuprofen as above. Click
here for more details.
I
have toothache, where can I find an emergency dentist?
Click
here for a rota of Brent and Harrow emergency dentists that
is held on the Harrow West PCG website. Emergency Dental
Treatment: Dentists that take part in the emergency rota will
have recorded on their machine the following mobile phone numbers:
These mobile phones are rotated between the dentists on the
enclosed rota. The dentists listed are obliged to treat
registered and unregistered patients if it is an emergency. For
those dentists who do not take part in our rota scheme they are
obliged to provide emergency care to their own patients.
My
period is late, do I need a pregnancy test?
If you are sexually active you need to consider pregnancy as a
possibility even if you use contraception as no method is totally
failsafe except sterilisation. If your period is late by a week
or more a pregnancy test will be reliable. They are available to
buy from most pharmacies. If you are pregnant and also have
abdominal pain and bleeding you need to consider the possibility
of an ectopic pregnancy or another pregnancy complication. In
this situation you need further advice from your doctor. Click here for more information
about the pregnancy test.
Why are you running so
late?
Usually because patients seen before you have required a
longer consultation. Some problems are complex or require a long
time to sort out. We try hard to give each patient as much time
in the consultation as they need and this applies to you as well
as everyone else that we see. We budget for ten minutes per
patient which gives usually gives us time to manage one major or
two minor problems. Problems arise when there are two or more
major problems that need to be dealt with today and can't be put
off or when seemingly minor problems turn out to be more serious.
It is helpful to us to spread minor problems over several
consultations but we understand that you would rather deal with
all your problems in one visit if possible. If you have more than
one thing to discuss please tell us at the beginning of the
consultation so that we can use the time efficiently. We would
love to have longer appointment slots but cannot do this without
more resources.
Have
you had a bad day doctor you look terrible?
If we look terrible, we probably feel terrible too. Doctors
are normal people, become ill and have problems and bad days just
like you. Thanks for noticing though; doctors have feelings as
well.
Clinic
times at the surgery - nurse, travel, blood pressure etc
You can make an appointment by contacting reception.
Have you got my results?
Pathology and X-ray results from the hospital usually arrive
within a few days. We usually tell patients to wait one week for
non-urgent results. Some blood tests take several weeks to return
because they are uncommon and done in batches in the hospital or
are sent to a specialist centre. If your doctor is asking for
these he/she will probably tell you about the delay. Cervical
smear results are posted direct to you by the health authority
but it takes the laboratory up to 2 months to process cervical
smears. The receptionists will be able to tell you whether
results have arrived but will not be able to give you results
over the telephone. If we need to know a result urgently we ask
the hospital to phone it through to us.
Have
you typed my letter for Dr. xxxx, I saw him today?
Your doctor will usually dictate your letter either whilst you
are in the consultation with him/her or as you leave. A log of
dictated letters is kept and our
secretary will do these as soon as possible in the order
they are dictated, although urgent letters are typed immediately
and if appropriate faxed through to the addressee. If the urgency
of the situation changes, please get in touch with our secretary and she
will inform you of the status of your letter and endeavour to
type it off if it is still waiting. Try not to bother her
unnecessarily as this will delay her work and sabotage our
attempts to maintain a very quick turnaround time.
Can
you bring forward my appointment at the hospital?
NHS waiting times are currently very long and our patients
receive no preferential treatment. We will certainly try to bring
your appointment forward if the urgency of your situation has
changed. Bear in mind that if you go up the waiting list, someone
must come down and ultimately it is the hospital consultants
responsibility to determine how to prioritize their very busy
workload. Using our secretaries to badger the hospital also
delays their work so it would be helpful if you could phone the
hospital admissions or appointments clerks yourself in the first
instance, or speak to the consultant's secretary directly. You
may get a better deal. We do try to push for early appointments
for the elderly because they can find the hospital direct call
system confusing.
How
long will I have to wait for my appointment?
Try phoning the appointments clerk at the hospital. Our secretary keeps the latest information given to us by the
hospital but this does alter from week to week and her
information may be out of date. Each clinic will have a different
waiting time and usually the consultant will prioritize patients
to be seen urgently, soon or routinely depending on the
information we provide in our referral.
Can
you recommend a Consultant for me - Doctor said you could?
Usually your doctor will recommend a particular consultant or
a choice of consultants that are suitable for your problem. Our
secretary is aware of the consultants that we routinely use for
certain problems and we will sometimes ask her to find the
consultant with the shortest waiting list if we are happy that
the quality of care you receive will not be compromised.
Contact numbers
for local hospitals
