Keep your medicine cabinet stocked for Christmas crises

Last-Minute Festive Pharmacy

Busy buying up last-minute presents and food?  Don’t forget to make sure your medicine cabinet is stocked with everything you might need to help you get through the excesses of food, family or frenzied over-indulgence. Here’s a few reminders:

Regular medications : make sure you have enough of these to get you through the holiday

Painkillers :   Keep a range of pain killers for both adults and children. Different ones work in different ways and suit different people and different pains. Be careful if you are taking cold-remedies too as these can contain paracetamol or ibuprofen  – make sure not to exceed the recommended dose.

  • Simple remedies such as cold or hot packs or creams such as Deep Heat or Deep Freeze, or herbal/complementary remedies that you prefer
  • Paracetamol
  • Ibuprofen (as an anti-inflammatory this may be better for soft tissue injuries like torn muscles)
  • Aspirin (not for children because of the potential for a rare but serious complication called Reye’s syndrome)
  • Codeine combinations

Indigestion medicines:  Simple antacids, especially those which contain a treatment based on alginates, which form a foamy raft that lines the stomach to protect it from acid, are essential for the misery of indigestion resulting from an excess of rich food. You might also want to consider drug treatments such as ranitidine or pantoprozole which reduce the amount of acid produced in the stomach. These can be very effective in severe heartburn and indigestion. You can buy short courses of these drugs from the pharmacy to cover the Christmas period without a prescription, but if your symptoms persist for more than a few days you should check things out with your doctor.

Decongestants, especially nasal drops or sprays, and herbal oils for inhalation. I like the small vaporising devices you can get for children’s rooms because I think they are safe and effective but skin rubs are much cheaper.

Cough medicines : whichever type suits you (I am not a great believer in the power of cough medicines, but most people like to have one to hand).

Treatments for sore throats : Simple boiled sweets, which help to keep saliva flowing over a sore throat, may be all that is need but some people find lozenges or throat sprays which containing antiseptics or local anaesthetics to be very helpful.

Antihistamines. Sedative ones, e.g. Promethazine or Chlorpheniramine,  may be useful for treating itchy conditions, stings, etc and can have useful sedative effects in small children. Newer versions are less likely to sedate.

Anti-diarrhoea medicines : Loperamide helps to slow the bowel down and reduce diarrhoea in gastroenteritis and other stomach upsets (Noro virus or “winter vomiting” is rife at the moment). Keep a stock of Rehydration solutions too, for children with gastroenteritis.

For women : citrate treatments for cystitis (these usually consist of powders which are mixed up as a drink to reduce the acidity of the urine and so reduce irritation) and creams, pessaries or tablet treatments for vaginal thrush.

An antiseptic cream or lotion for simple cuts and grazes

A simple first aid kit: You can buy ready-made ones, but its much cheaper to put your own together. Good items include  :

–       Two cotton bandages and 2 crepe bandages of different widths

–       Wound dressings and a pack of gauze swabs

–       A variety of plasters including some for children

–       An ice pack

–       A thermometer

–       Safety pins

–       Surgical tape

–       Scissors

–       An eye patch

–       A large triangular bandage (which can be used to make a sling)

–       An eye bath and eye wash


Follow the rules :  Finally remember some basic rules :

–       always finish prescribed courses of medicine, or dispose of any left-overs safely (take them to the local pharmacist if you are worried).

–       Never take medicine prescribed for someone else

–       Make sure your cabinet and its contents are safe especially from small children (place it high up, lock the doors, ensure proper childproof caps are used etc)

–       If you don’t know what something is for, get rid of it.

–       Don’t keep medicines past their use-by date. It’s unlikely that they will “go off“ or be harmful but they may lose any therapeutic effect.

And don’t forget – the worst hangovers improve with hydration and rest. Alcohol is dehydrating so drink plenty of plain fluid and try to squeeze in a nap when you can.


Driving with Diabetes

Do you have diabetes and want to find about how this will affect your driving? Or perhaps you know someone who has diabetes who you think shouldn’t be driving. Watch the following video to learn more about informing the DVLA and all your options…

There’s a whole myriad of different conditions that could impact on whether you can drive or not and that you need to tell the DVLA about.

I thought I’d look at two in particular. And the first of those is diabetes. There’s lots of specifics, so if you’re a diabetic, you do need to check with the DVLA website. Just to look at a couple of things in general, if you’re just on drug treatments and not on insulin then you may not have to inform the DVLA of your diabetes. This is only long as your diabetes is well controlled and you’ve had less than one episode of hypoglycemia or of a low blood sugar within the past year and you don’t have any complications affecting your eyesight or peripheral vascular disease.

So, to summerise, if you don’t have any other ongoing health issues and you’re well controlled, then you don’t have to inform the DVLA. If you’re an insulin-dependent diabetic, if you need to take insulin, then the DVLA need to know. There’s also a whole long list of specifics about control of your disease that they need to know about and you need to think about.

For example, in the first month of using insulin, you shouldn’t drive.
This is because when first start getting used to insulin and finding the right dose for you there is a risk that your blood sugar may drop lower than is ideal, certainly lower than 4. This means you really shouldn’t be driving because there’s a risk that you’ll lose control of the car. So, don’t drive in the first month.

You need to inform your insurance company that you’re on insulin as well, because it may have implications with them. One very important point is that you need to check your blood sugar regularly. All diabetics do anyway, but you need to know before you step into a car, every single time you go out to drive.

You need to have some sort of record of what your blood sugar is and if it’s less than 4 then you shouldn’t be driving at that particular time. This is because you could find that, if you had an accident and you were unable to provide evidence of your blood sugar from the time before you got in a car, the insurance company won’t validate your insurance. So, you have to have proof that when you step into the car that your blood sugar is good enough for you to be driving. You need to consider all the specific complications, particularly once you’re on insulin with diabetes and you need to have evidence that your diabetes is well controlled.

So, lots of things to think about; be diligent with checking your blood sugars. Make sure everybody’s up to date, and it doesn’t mean you can’t drive just because you’re diabetic. You just need to be on top of the situation, gather all your information, and be well-controlled.

Supporting Someone With Dementia Who Shouldn’t Be Driving

Do you have a friend or family member who sufferers from dementia and who therefore should not be driving? Watch the following video to learn the steps you might want to take to approach this sensitive subject…

Relatives or carers frequently ask me what they should be doing when they’re concerned that a person in their family is still trying to drive and shouldn’t be. This is a very difficult situation and I think the first step is to try and encourage someone to go and talk to their doctor about it.

Often when you think someone is a little confused or you think their dementia has gone undiagnosed; there may be reversible elements. There may be an undiagnosed condition, maybe an underactive thyroid or anaemia or some other issue that’s muddling their mind. There may be steps that can be taken to help people improve their help and improve their situation. Also that can be the fist step to identity that someone had cognitive issues or some sort of earlier dementia.

Its much easier then to move the issue from the relative or the loved one into the hands of the professional because the doctor can then advise the patient that you really shouldn’t be driving, you need to contact the DVLA that there’s an issue or that you need to take a further test and asses and make sure that you are competent to drive. This makes it much easier for a relative or carer who feels they can’t take action to then be able to stand up and say for instance ‘your doctor says you’ve got to do something about this’, so it gives you a bit of power and authority to get things done.

Quite often people go on driving anyway. I’ve had lots of patients who will in one way or the there get in the car, find the keys or have a spare key hidden away somewhere. It’s such a basic freedom to be able to drive so people loathe to give it up. So sometimes you do need to resort to other tactics to hide the keys, deactivate the car or even move the car somewhere else. There may be arguments or issues that you have to work through but, as long as the person has plenty of other options for getting about, then you can work your way around the issues.

Any ideas that you may have as to how people may tackle it then write them down, add them to the blog as they could be useful!

Driving with Dementia

During the early stages of dementia many symptoms may make driving harder and unwise. Watch the following videos to learn more…

Another topic regarding driving and health that a lot of people need information on is when people start to get into the early stages of dementia.

When dementia develops, a lot of aspects can influence driving. Reaction times slow, memory of where you are and where you’re supposed to be going also start to slow. Short-term memory particularly starts to slow. So you may get in the car.

I’ve had patients tell me how they’ve got in the car and then had no idea where they’re supposed to be going. So that’s a bit of a disaster waiting to brew. Confidence in driving decreases with Dementia patients, so people get in the car and then they become very shaky and uncertain.

In fact, studies have shown that with older people having accidents, about 1 in 3 are later found to have Alzheimer’s, so, it certainly plays a part in driving accidents going on.

On the other hand, people, because of the independence of driving, still cling to the ability to get out there and get in their car and get about. We know from other research that one of the things that stops people driving and really makes them take stop, is when they get as far as having an accident or a near-accident. This means that most people with dementia don’t stop driving until forced to do so, often by an accident and clearly that’s not a great situation.

So, you need to consider, for yourself, or for relatives, if you know that they’re really not quite as sharp as they used to be, that maybe it’s time to start thinking about whether they should be driving or not.

Now, dementia itself isn’t a bar to driving at all in the mild, early stages. But what’s best is to be sure that you are safe and to take a further driving test. You can talk to the DVLA and they will recommend a local center where you can have an update of your test to make sure that you’re still safe to drive.

It’s also important to bear in mind that if you know that you have some degree of dementia, or you know a relative does, that that may invalidate their insurance if the insurance company hasn’t been told. So, just as with other health issues, you just need to accept what those issues are and look at how the rules and regulations change and make sure you’re complying with those.

As dementia advances, then really it is time to start thinking about using public transport, getting relatives to take you places or even, when necessary, taking a taxi. Increasingly, these days you can go shopping online and do a lot of other things online, so get help from your relatives to do so.

Should I Be Driving?

Driving is a major part of peoples’ lives and one which can be threatened with increasing age or certain illnesses or disabilities. Whats steps should you take in these circumstances? Watch to find out…

So, what do we need to think about in terms of whether we can drive safely in relation to an illness or our age?

First of all, it’s really important to say that illness, getting older, a little less strong, and a little less fast is no bar to driving. On the other hand there are lots of specifics we have to think about.

No matter what your age, if you’re 20 or if you’re 80, you do have to inform the DVLA if you have some sort of health condition that could impact upon your driving ability. You also need to inform the DVLA if you have some sort of disability that’s going to last more than three months.

So, the general rule is if you have an acute illness, if you’re not well for a week or two of course you should follow common sense and not drive if you’re really not very well. But, in this case, you don’t have to inform the DVLA unless it goes on for more than three months.

In that case, they would then send you a form all about different medical conditions asking you lots of questions. You’d be expected to fill that form in and return it to the DVLA and then they will advise you. And often it’s not a case of banning you from driving but just looking at more specifics and asking for further advice.

You also need to think about your insurance company, because if you’ve informed the DVLA of a disability your insurance company also needs to know. If you don’t inform them you may find your insurance is invalid so you need to tell them about it, too, and there may be limitations on your driving.

That’s the sort of general situation for everybody. It can be very difficult to accept that you shouldn’t be driving anymore, but there will be times, and for some people when you just have to look at alternatives.

Age, health and driving – what do older drivers need to know ?

Being able to drive yourself, or your family and friends about may be vital in staying independent, and provides a freedom that most drivers value very highly. But there’s no doubt that as we get older a number of health problems can have implications for driving and I often have to talk to patients or their families about this. So how can you stay safe driving in older age ? What does the law say about health issues and driving ?  And how can families help their relatives if it’s time to stop driving ?  I’ve got a few points to make here but I’d love to know your thoughts !  Trisha

Hi, I’m Trisha. Today I’m going to talk to you about issues around driving and health as these are some of the problems that have come up on the ward this week.

First of all, I had one patient I was talking to who’s quite severely ill and in bed, and I talked to him about how he normally gets his shopping. He said, normally he’d just get into his car and go down to the shops. Thinking about how he’s been affected by his illness, I’m rather worried that actually he’s not going to be able to do that that any more. I therefore wanted to explore with him what other options he had and what he was going to do about it.

At the same time, I had some relatives come in and they came to visit a loved one of their similar sort of age. They were all in their 80s. And they came in, visited, and went out again. Then, 10 minutes later, one of them came back onto the ward and said “I’m really sorry, but I’m completely lost. I don’t know where I’ve parked my car and I don’t know how to find it and get out again.” Now, we’re only a small hospital. We’ve got about 40 parking bays. We’ve got one gate into the hospital and one out. So, this immediately rang bells that these relatives, or the person driving, actually could have some sort of cognitive issue or even an early kind of dementia going on. The more I talked to them, the more I became aware of this and I was helpless. I couldn’t do anything with them because they weren’t my patient, but it’s still a common issue we see that there a lot of people who are still driving who maybe shouldn’t be.

It’s very difficult, as we get older, because if you are no longer able to drive, you lose a very important freedom. It limits your independence. You can no longer get out and get what you need in terms of shopping or getting various chores done. You can’t get to the bank. You can’t do all sorts of things. You can’t visit your friends. You can’t socialize in the same way, and you become dependent on other people. I see that all the time on the wards that various stages of illness are making people, as they get older, more dependent on others. Most of us don’t like that at all. And it limits our quality of life.

Therefore I thought it would be quite good to look at some of the issues around driving and health and what we should or shouldn’t be doing.

Welcome To My Blog: Notes From The Ward

Hi I’m Trisha Macnair, I’m a part-time geriatrician working with the elderly and would like to share with you some of the health issues that I often have to help people with.   Many are problems that we all face in some way, either because they affect us directly or one of our family or loved ones, and your perspective on them is vital.  I really hope that you will contribute your own thoughts and ideas to this discussion because between us we may be able to offer something useful to others going through the same problems.   I look forward to your feedback, enjoy!

Hello. I’m Trisha MacNair and I’m a part-time geriatrician working with the elderly in a small rehab hospital in Surrey.

We look after people who’ve had a major illness: an episode like a stroke or pneumonia, or a very big operation and they’re just taking a long time to recover.

In our hospital we have lots of really good therapists, so we give them all sorts of therapy and treatment. My role is that I help to look after all their medical issues and we usually, get them back home, which is where they want to be.

I thought it might be interesting if I shared with you some of the cases and the sort of issues that crop up a lot.  They’re often issues that affect everybody that relate to us, maybe not necessarily affecting us, but our parents or our loved ones or those in the community around us.

I want to raise the sort of questions and difficult situations that we all need to know a bit more about and maybe have some very interesting things to add to those issues. So, I’m really hoping that this will stimulate you to come up with your own comments and ideas and suggestions and actually add to the blog as well.

I’m really hoping that it’s not just going to be me blabbing away to you, but lots of you are going to join in with the discussion. So, do feel free to leave any comments you want to make on the blog, too.