Reducing the effects of overindulgence this Christmas

We want to enjoy the festive season, yet all too often, indulgence leaves us feeling heavy and bloated. Poor digestion is what causes waste gases and sluggish bowels, which in turn lead to bloating – the stomach feels uncomfortable, full and tight including a visibly rounded or bloated stomach.

Tips to reduce that bloated feeling this Christmas

Preparing healthier Christmas dinner                                                                         

Use wholegrain breads for stuffing. Cook stuffing separate to the meat so it doesn’t soak up fats during cooking. Substitute light or low-fat spreads for butter when baking. Use yoghurt or buttermilk in baked goods, both low in fat and calories. Instead of high calorie cream sauces to go with meat and starters, try making vegetable puree ones like red pepper and onion. Try to avoid eating the skin of the turkey as the skin is high in fat. Roast potatoes have a higher fat content than normal potatoes. However, if you cut them into larger chunks or use larger potatoes when cooking they will absorb less fat.

Moderation                                                                                                                    

Use a smaller plate, your mind will consider it a full plate regardless of its size. Where there are choices, take a little of many things rather than lots of one thing. This ensures you are getting a balanced meal and not overloading on a fatty food. For every glass of alcohol or soft drink, have a glass of water. Water fills you up and helps wash out the excesses. Only put out some of the available food so people don’t over serve themselves. More can always come out as required. Try to eat slowly throughout the day to avoid that uncomfortable full feeling. It takes your brain a few minutes to realise you are full. If you feel full, try to resist the temptation to stuff in another mouthful. Take a break instead.

Eat fresh food instead of processed food

Many processed foods are made with trans fats, saturated fats, and large amounts of salt and sugar. It is important to eat more fresh food, especially for children as the vitamins and minerals from fresh food will aid their development.

Processed foods that are less healthy include 1. Canned foods. 2. White breads and pastas (whole grains versions are the healthier). 3. Packaged high-calorie snack foods such as crisps. 4. Chips. 5. High-fat convenience foods such as cans of ravioli. 6. Packaged cakes and biscuits. 7. Sugary breakfast cereals. 8. Microwaveable meals. 9. Frozen fish fingers. 10. Processed meats.

Processed meats are of particular concern. They are extremely high in fat and salt. Fresh meats, fish and hams from the butcher or meat counter in your supermarket is the healthier option. Short term over indulgence on processed foods will lead to bloating, indigestion and sluggishness. However long term use will lead to obesity and associated complications like diabetes, heart disease and cancer.

This article is shortened for this Health Blog.. More detailed information and leaflets is available in Whelehans or check www.whelehans.ie

Eamonn Brady is a pharmacist and the owner of Whelehans Pharmacy, Pearse St, Mullingar. If you have any health questions e-mail them to info@whelehans.ie

The myths about alcohol and hangovers (uncovered)

With Christmas party season well and truly underway I thought it would be a good time to discuss facts about alcohol and dispel some of the myths we have about alcohol. Alcohol is safe if drank in moderation. Alcohol releases endorphins in the brain which is why it makes us feel good (and why it is so addictive); it also affects the area of the brain that causes inhibition which is why it makes us talk more and feel more relaxed. In this article I only discuss the short term effects of drink. There are also many long term health dangers of heavy drinking. According to Dr Conor Farren, a consultant who deals with alcohol addiction in St Patrick’s hospital in Dublin, abuse of alcohol can cause 63 different diseases to our body. I will discuss these long term health effects including addiction in my health blog in 2014.

What causes a hangover?
The unpleasant symptoms experienced during a hangover are mainly caused by three factors. (1) The diuretic effect of alcohol that causes the drinker to pass more urine and thus become dehydrated. (2) The toxic effects of by-product of alcohol metabolism (acetaldehyde) (3) Depletion of vitamin A, vitamin C, the B vitamins (especially vitamin B6), magnesium, potassium and calcium. Co-geners are another cause of hangovers. These are impurities created during the fermentation of some types of alcohol. Low quality wines and dark drinks tend to have high levels of co-geners. A general rule of thumb is the darker your drink, the worse the hangover. Certain chemicals added to some drinks such as preservatives and sweeteners also make the hangover worse.

The symptoms of hangovers

Symptoms of hangovers can include some or all of the following class of symptoms:

Constitutional: Fatigue, weakness, and thirst. Pain: Headache and muscle aches. Gastrointestinal: Nausea, vomiting, and stomach ache. Sleep and Biological Rhythms: Decreased sleep including decreased deep sleep which means the sleep you do get does not leave you refreshed. Sensory: Dizziness and sensitivity to light and sound. Cognitive: Decreased attention and concentration. Mood: Depression, anxiety, and irritability. Sympathetic Hyperactivity: Tremor, sweating, and increased pulse and blood pressure.

How long will a hangover last?

Hangover symptoms usually begin within a few hours of the drinking session ending when the blood alcohol concentration (BAC) begins to fall. The symptoms usually peak at the time when the person’s BAC returns to zero. Hangover symptoms can last from a few hours to up to 24 hours. Some binge drinkers develop a tolerance for alcohol which means they do not get hangovers, however their performance at work or other areas of their life will be

Is there a cure for hangovers?

There is no cure for a hangover. Apart from drinking in moderation (or not drinking) there is no guaranteed way of preventing one. Hangover cures are generally a myth. Dehydration is the main culprit; three times as much fluid is lost than is taken in while drinking alcohol because of the diuretic effect alcohol has on the kidneys; this is because alcohol inhibits a hormone called anti-diuretic hormone (ADH). The symptoms of a hangover can be reduced by rehydrating with water before going to bed. The best way to deal with “the morning after” symptoms is to rehydrate by drinking plenty of fluids. You can replace lost fluids by drinking bland liquids that are easy on the stomach such as still or sparkling water and isotonic drinks. Water also helps dilute the leftover byproducts of alcohol in the stomach. Adding salt and sugar to water helps replace the sodium and glucose lost the night before. Many believe that fatty or fried foods the next morning will ease the symptoms; however this is more likely to irritate an already delicate stomach. Over the counter painkillers can help with headaches and muscle cramps. Sugary foods may help reduce trembling. An antacid may ease an upset stomach. Food helps slow the absorption of alcohol so it takes alcohol longer to reach your blood stream, thus reducing the risk of becoming intoxicated and your hangover may not be as bad. Lining the stomach with a glass of milk before drinking may slow down the absorption of alcohol very slightly. Replenishing vitamins and minerals lost may help as alcohol robs our body of many vitamins and minerals. Some people believe that taking a supplement such a vitamin C or B complex supplement can help.

Why do hangovers get worse as we get older?
Many of us have heard people saying (or said it ourselves) that hangovers get worse as you hit your 30’s or 40’s compared to when you were in your early 20’s. Is this just our imagination? There is truth in this and there is a scientific explanation. Our body uses the enzymes alcohol dehydrogenase (ALDH) and aldehyde dehydrogenase (ADH) to break down alcohol. As we get older, these enzymes reduce in efficiency meaning that it takes longer for the body to get rid of the toxic byproducts of alcohol such as acetaldehyde which leads to longer and more unpleasant hangovers.

Eamonn Brady is a pharmacist and the owner of Whelehans Pharmacy, Pearse St, Mullingar. If you have any health questions e-mail them to info@whelehans.ie

Eye Spoons- A new “drug free” treatment for dry, inflamed or itchy eyes

I decided to discuss “eye-spoons” this week as I have been getting a lot of enquiries about how they can help eye conditions since their launch earlier this year. Dry eyes or inflammatory eye conditions can include symptoms like itchy, red, irritated and swollen eyes. Dry eye mostly occurs as a part of the natural ageing process, affecting about a third of people over 65. Meibomian gland dysfunction is a condition where the glands at the eye lids become blocked with thick secretions leading to unsightly swelling around the eyes and inflamed and irritated eyes.

“The Eye Spoon”

“The Eye Spoon” is a drug free treatment option designed for many of the most common and annoying eye problems. It is an Irish invention. The concept of The Eye Spoon was developed by Dr Micheal J Gallagher, a Consultant Ophthalmic Surgeon who has a monthly ophthalmic clinic at St Francis Private Hospital in Mullingar.

How does it work?

Dr. Gallagher’s invention provides a method for applying heat effectively to the human eyelid. The apparatus consists of a spoon-shaped device comprising a wooden oval heat applicator with dimensions sufficient to cover a human eye, with an elongated handle extending from the applicator. Initially, the device is placed into boiling water in a mug for 20 seconds. Once removed, air dry for 20 seconds to prevent scalding. The Eye Spoons are then applied directly to both eyes until the heat subsides. The device is designed for safe use, whilst retaining sufficient heat to treat the affected eye.

The eye spoon targets the eye’s meibomiun glands, freeing up their secretions into the tear film, hence easing dry eyes and reducing inflammation of the glands.

Studies

Study results reveal that use of the product is effective in the treatment of dry eye, external eyelid disease (blepharitis and meibomianitis), both causes of the most common complaints of dry, red, scratchy and itchy eyes. Studies show that 80% of those patients with dry eye syndrome found the eye spoons to be of benefit. Studies demonstrated that eye spoons represent an effective method of treatment for dry eye syndrome and external eyelid disease.

In Whelehans, I am seeing some good results for those using it and in some cases, it is the first consistent relief some people have found in years. Unlike drugs and drops, it is a one-off purchase of €18.95 which includes two eye spoons. As it is re-usable, once purchased, there are no on-going costs. This article is shortened for this health blog so call into Whelehans or check out www.whelehans.ie  if you want more detailed information or if you feel they could benefit you.

Disclaimer: Please ensure you consult with your healthcare professional before making any changes to your medication

 

Eamonn Brady is a pharmacist and the owner of Whelehans Pharmacy, Pearse St, Mullingar. If you have any health questions e-mail them to info@whelehans.ie

 

 

 

Flat Feet

Eamonn Brady is a pharmacist and the owner of Whelehans Pharmacy, Pearse St, Mullingar. If you have any health questions e-mail them to info@whelehans.ie

During childhood, usually between the ages of 3 and 10, we develop a space (arch) on the inner side of our feet where the bottom of the foot is off the ground. People with a low arch or who have no arch are classified as having flat feet, sometimes referred to as having "fallen arches".

Causes

Flat feet can run in families, and both feet are usually affected. Occasionally, flat feet are due to a problem in the way the foot forms in the womb, in this situation, the feet are stiff and flat and the problem is usually noticeable during childhood.

Another form of the problem is when the foot has a tendency to roll inwards too much while standing or walking. This can be due to weak ligaments in the heel joint or at the base of the big toe. "Pronation" or "over-pronated foot" is a term for excessive rolling of the feet. 

While over-pronated feet usually develop in childhood it can sometimes develop in adulthood. Flat feet may develop due to a ruptured tendon (which is rare), tear of the spring ligament (also rare), arthritis, nerve damage due to diabetes, or injury which leads to stiffness and distortion of the joints of the feet. Conditions of the nervous system or muscles including cerebral palsy, spina bifida or muscular dystrophy can cause flat feet as they can cause muscle weakness or lack of movement in the muscles. These conditions lead to the feet becoming stiff which get worse as the condition develops. Other contributing factors can include shoes which limit toe movement such as high heels (walking barefoot may have a protective effect). Tight achilles tendon or calf muscles can also make a person more prone to flat feet. Obesity also can contribute to flat feet.

 When is treatment needed?

Most flat feet do not cause any problem so no treatment is needed. Reasons to look for treatment include pain (not eased by any type of foot wear). Pain from flat feet can occur in a number of areas including inside the ankle, at arch of the foot, the outer-side of the foot, calf, knee, hip or back. Other reasons for seeking treatment include wearing out shoes quickly, feet appear to be getting flatter, feet tire easily, swelling on the inside bottom of feet, feet are stiff and lack of feeling in the feet or weakness.

 Treatment

No treatment is required if flat feet do not cause problems. Well-fitted shoes, especially extra-broad fitting types of shoes can help. For people suffering from over-pronated feet, a special insole, which prevents feet rolling over too much, can ease the problems. These specialised insoles can be advised on by a chiropodist or a physiotherapist. These insoles are also called orthotics and are available in pharmacies. A more permanent solution is a customized orthotic, whereby an orthotic is specifically designed for your foot. Measurements for this type of insole are taken, by your chartered physiotherapist, from a plaster cast of your foot or by stepping into a foam box. These are then sent on to a lab where the custom insole will be created.

 If pain occurs, rest, ice and over-the-counter non-steroidal anti-inflammatories, or NSAIDS (eg. ibuprofen) can give temporary relief. Children with an abnormal foot that has not developed properly may require an operation to straighten the foot or to separate bones that have fused. Luckily operations are rarely needed as these are rare causes of flat feet in children. Other actions that can help include wearing footwear with lower heels and wide toes, losing weight if appropriate and doing appropriate exercises that strengthen muscles in the feet which can include walking barefoot, exercises called toe curls (flexing the toes) and heel raises (standing on tiptoes).

Heel cord stretching exercises

These stretch and lengthen the achilles tendon and posterior calf muscles. Your physiotherapist is best for advising on appropriate exercises.

How to do:

Stand facing a wall with your hands on the wall at about eye level. Put the leg needing stretching about a step behind the other leg. Keeping the back heel on the floor, bend the front knee until you can feel a stretch in the back leg. Hold the stretch for 15 to 30 seconds. Repeat 2 to 4 times. You should aim to do this exercise 3 to 4 times a day.

Physiotherapy

Whelehans physiotherapy service is with Chartered Physiotherapist Sinead Brogan. Reduced rates for over 60’s and affiliated sport clubs. Book a physiotherapy appointment by calling Sinead at 083 1722171. Sinead can also treat flat feet. Physiotherapists can perform a detailed investigation to assess foot and lower limb function. Specific patient related treatment can then be implemented to accurately treat and manage health and exercise issues pertaining to this condition. This exercise program addresses identified muscle weaknesses and imbalances and is often sufficient to alleviate pain and restore normal function. If the exercise regime or temporary insole or orthotic is not sufficient to relieve the problem, Sinead can measure you for a more permanent customized orthotic (as described above). Our Chiropodist James Pedley can also advise on flat feet in adults and children; to book his clinic for adults or children call 04493 34591 and he also has reduced rates for over 60’s.

This article is shortened for this health blog. More detailed information and leaflets is available in Whelehans or www.whelehans.ie

Osteoarthritis

Osteoarthritis is by far the most common form of arthritis. Unlike rheumatoid arthritis which is caused by inflammation, osteoarthritis is caused by long-term wear-and-tear in the joints. After years of use, the cartilage that cushions the joints can break down, until bone rubs against bone. Osteoarthritis is rarely as crippling as rheumatoid arthritis, but it can have a big impact on a person's life. It can make it hard to do every day activities like getting dressed and walking up the stairs. It most commonly affects the knees, hands, hips and spine. It does not affect both sides equally and symmetrically as commonly as rheumatoid arthritis. Osteoarthritis is the cause of knee pain in over half of people over 55. It is not to be confused with osteoporosis which is “brittle bone disease” and not related to osteoarthritis.

 Who is affected?

Osteoarthritis is the number one reason for joint-replacement surgery.  It can take decades for enough cartilage to wear down to cause osteoarthritis. It occurs mostly in men after the age of 50 and in women after the age of 40. After menopause, women are twice as likely as men of the same age to develop the condition. Being overweight and a family history of arthritis makes you more prone to the condition. However, it has less of a tendency to run in families than rheumatoid arthritis. Playing a lot of high impact sport (eg. Gaelic football and rugby) and having an injury or an operation on a joint can make you more likely to have problems later on.

Symptoms

The main symptoms of osteoarthritis are pain and stiffness of the joints. The joints may also become swollen although this is less common than in rheumatoid arthritis. Unlike rheumatoid arthritis, where pain and stiffness tends to be worse in the morning, the pain of osteoarthritis tends to get worse throughout the day. The joints may not be able to move as easily as before. There may be a crunching feeling in the joints. Joints may make creaking sounds called crepitations. Joints may become misshapen and knobbly, and they may become unstable (but generally not as severe as with rheumatoid arthritis).

Diagnosis             

Unlike other forms of arthritis, there is no single test that can check for osteoarthritis. Outgrowths, swelling, creaking, instability and reduced movement of the joint can be signs. X-rays only give limited information and in the early stages of osteoarthritis, joints may look normal.

Treatment

Certain actions can prevent and reduce the symptoms of osteoarthritis including losing any excess weight, wearing shock-absorbent shoes, using a walking stick and wearing a knee brace. Taking regular exercise is important as it keeps weight down and strengthens muscles which support the joints.

Medicines

There is no cure for osteoarthritis however certain medication will relieve symptoms.

Paracetamol- Over-the-counter painkillers such as paracetamol can help. Paracetamol is safe for most patients once taken within the recommended dosage limits.

NSAIDs- If the pain is more severe, the doctor may prescribe anti-inflammatory medicines known as non-steroidal anti-inflammatory drugs (NSAIDs) to reduce the inflammation. These are helpful in reducing pain, swelling and stiffness. Examples include diclofenic (Difene^®, Diclac^®), naproxen (Naprosyn^®) or etoricoxib (Arcoxia^®). Ibuprofen is an NSAID available over the counter in pharmacies. NSAIDs should be avoided or used in caution with asthma and heart problems and can cause stomach ulcers if over used.

Topical preparations- Many NSAIDs are available in topical forms such as creams or gels which can be rubbed on to give a local effect (eg) Difene Gel^®, Fastum Gel^®. These topical forms have fewer side effects than NSAIDs taken orally. However they are likely to be less effective as less of the drug is absorbed.

Opioid Analgesics- Opioid analgesics such as tramadol are prescription only painkiller which may be considered in cases where NSAIDs are not tolerated or ineffective. However, opioids can become additive. Side effects include drowsiness, nausea and constipation.

Steroid Injections- Steroid injections into the affected joints may be a treatment option. It should only be considered where there is inflammation in the joint. However, the effects of steroid injections only last up to four weeks (often only a week) so it is not a long term solution.

Surgery

Surgery should only be considered when all other options have been tried. Surgical options available have advanced recently. Some options such as realignment and hip resurfacing are available even if you have only mild osteoarthritis. Hip resurfacing is an alternate to hip replacement and is more often used in younger patients.

It involves replacing the socket where the top of leg attaches to the pelvis with a “metal socket”. The advantages of this compared to hip replacement is that it is very durable for young and active patients. It allows the patient to maintain full mobility and even return to active sports in many cases. Some research shows that there is less pain and stiffness after hip resurfacing compared to hip replacement. However more research is needed to confirm this. Patients normally can resume normal daily activities a few weeks after hip resurfacing. Hip resurfacing lasts for 10 to 15 years on average.

If you have a particularly painful joint you may need an operation to replace it. This is most commonly done for the hip and knee joints and both of these have high rates of success in improving mobility and reducing pain. With proper selection of patients, 95% of hip and knee replacements have excellent results with 95% of replacement joints lasting 15 years. 85% of hip and knee replacements are due to osteoarthritis.

Whelehan’s physiotherapy service

Whelehans physiotherapy service is available on Wednesdays and on Saturday mornings. Book a physiotherapist appointment by calling Sinead at 083 1722171.

 Osteoarthritis information event

Whelehans Pharmacy in conjunction with the Westmeath Branch of the Arthritis Ireland are hosting an Osteoarthritis Information evening on Wednesday November 20^th in the Annebrook Hotel, Mullingar at 7:30pm. The guest speaker for the evening is orthopaedic surgeon from Midland Hospital Tullamore, Eoin C Sheehan, MD FRCS (Ortho). Book your free place by calling Whelehans at 044 93 34591.

 This article is shortened to fit within this Health Blog. More detailed information and leaflets is available in Whelehans or check www.whelehans.ie

Eamonn Brady is a pharmacist and the owner of Whelehans Pharmacy, Pearse St, Mullingar. If you have any health questions e-mail them to info@whelehans.ie

 

Breast Cancer facts

Every 3 hours a woman in Ireland is diagnosed with breast cancer. In this week’s Health Blog I give some facts and figures about breast cancer which is the second most common cancer in women after skin cancer. More than 2000 new cases of breast cancer are diagnosed in Ireland each year. Irish women have a 1 in 12 chance of developing breast cancer in their lifetime. Only about five to ten per cent of breast cancers are believed to have a family link. The risk of developing breast cancer increases with age. Approximately 80%of breast cancers occur in women over 50 years. Around 14 men develop breast cancer in Ireland each year. Breast Cancer is the second most common cancer in Ireland. Early diagnosis is a key to surviving breast cancer. If you do notice any change in your breasts, see your GP as soon as possible. 9 out of 10 suspicious lumps are not cancerous. Many women over 40 have calcium deposits (calcifications) in their breasts, and most of them are benign. Pain isn’t usually a sign of breast cancer. If you have pain in one or both breasts, rest assured it’s probably due to hormonal changes, a benign cyst, a ligament strain or another condition; however it is important to get unexplained pain checked by your GP. Don’t worry that you may be making an unnecessary fuss. More common warning signs of breast cancer include a palpable lump, a change in the size or shape of the breast, puckering of the skin, nipple changes (like scaling or discharge), or increased warmth. A mammogram (X-ray of the breast) is the most common way to check for breast cancer. 80.6% of all women diagnosed with breast cancer survive for 5 years or longer; early detection is the key to survival.

 Importance of self-checks

Self-checks are vitally important; 74% of Irish women with breast cancer discovered the lump themselves. It’s good to do them at the same time every month. What self-exams do is help you become familiar with what’s “normal” for your breasts. So when something’s off, you’ll know and can bring it to your doctor’s attention. After all, you know your body better than any doctor does.

 What happens if my GP sends me for a breast check?

Your GP will refer you to a specialist breast clinic in a hospital if he/she has any concern about your symptoms; for example if you have a lump in your breast. At the hospital, you may have triple assessment. Triple assessment uses three ways used to assess your breasts. It starts with the doctor taking a medical history or list of any health problems you have had in the past and then examining your breasts and underarms. Next you may be sent on to the X-ray department for the next step which may be a mammogram (x-ray of the breast) or an Ultrasound scan or both. Finally a biopsy which may be a fine needle test or core biopsy. If you do not have a lump you may not need full triple assessment.

BreastCheck Screening Programme

BreastCheck is a programme  funded by the Government which provides breast screening and allows women aged 50 to 64 to get a free mammogram on an area-by-area manner every two years. BreastCheck reduces deaths from breast cancer by finding and treating the disease at an early stage. Screening has been proven to reduce the number of deaths from breast cancer, as the disease is very treatable if detected early. BreastCheck invites women aged 50 to 64 for a free mammogram on an area by area basis every two years. In order to be able to invite women in the 50 to 64 age group, BreastCheck has a register of women eligible for screening but there are times when your details could be missed. If you haven’t got an invitation you can register for BreastCheck by calling freephone 1800 45 45 55. The Breast Check website (www.breastcheck.ie) has details of screening locations in your area. Breast Check screenings are life-saving so don’t delay getting yours

Some quick tips on Breast Cancer Prevention

Active women are less likely to develop and die from breast cancer. A Recent American study suggests that women with high aerobic fitness levels have a 55% lower chance of dying from breast cancer than their less-fit peers. So get moving! Having two or more drinks a day increases breast cancer risk by about 25%. Embrace a diet high in vegetables and fruit and low in sugared drinks, refined carbohydrates and fatty foods. Stop smoking, smoking is associated with increased risk of breast cancer in some women. Growing evidence suggests that getting enough of the B vitamin folate (in leafy green vegetables, beans and fortified cereals) may help mitigate the increased cancer risk associated with drinking alcohol. Being overweight, especially after menopause increases your breast cancer risk. So if you’re overweight, you have higher amounts of circulating oestrogen, which could stimulate breast cancer growth. Even losing a few pounds can reduce your risk significantly. Breast-feed your babies for as long as possible. Women who breast-feed their babies for at least a year in total have a reduced risk of developing breast cancer later. For more information, call the National Cancer Helpline at 1800 200 700 (Monday to Friday)

Whelehans Pharmacy, 38 Pearse St, Mullingar (opposite the Greville Arms Hotel). Tel 04493 34591. Web. www.whelehans.ie

Ligament Injuries (Sprains)

Ligaments connect bone to bone. Ligaments help stabilise the joint, maximising strength and preventing excess movement. Ligaments are sprained when the joint is stressed beyond its normal range. Common causes of a ligament injury include twisting or landing awkwardly. Most ligament injuries if treated properly can mean a return to normal activities and sport between 4 to 12 weeks. Your physiotherapist is correct, strengthening exercises are important. A physiotherapist is an expert on sports injuries and is best placed to advise on ligament injuries. I will give some general tips here but for more specific and detailed advice, ask your physiotherapist.

 General treatment tips for ligament injuries        

It is essential to rest the injured ligament for at least the first 48 hours. Avoid any activities that could further aggravate it including sports.

Icing the injured area is important for the first 48 hours. Apply ice wrapped in a towel or other cloth to the injury for 15-minute intervals, once per hour on the first day. On the following days, ice the hand for 15 minutes once every 3 hours. The ice reduces inflammation and swelling. After about four days, applying heat to the affected area can help; heat increases blood flow in the area thus reducing inflammation by releasing inflammatory substances from the affected area.

Keeping the injured area elevated higher than the heart ensures blood does not pool around the injured ligament and reduces swelling and allows the injured ligament to heal quicker and correctly. For example, keep the affected hand or ankle elevated during sleep by propping it up using pillows. Try to sleep on your back.

A support or brace may be required to ensure the injured area is kept immobile and in the correct healing position. The brace should be tight enough to keep the area rigid, but not so tight it constricts blood flow. Once the injury is well enough to return to sports, it is important to strap the affected area. The good method of strapping to protect hand ligaments is called “spica” strapping. Your physiotherapist will show you how to do this. There are also youtube videos demonstrating how to do spica strapping. Anti-inflammatory drugs will reduce inflammation, swelling, and pain around the injured ligament. Over-the-counter drugs such as ibuprofen can work effectively.

Alternative treatment

There are no alternative treatments that will cure torn ligaments, however some supplements may help reduce inflammation so may accelerate healing. Alternative treatments are not meant to replace conventional treatment and advice from your physiotherapist. They may compliment conventional treatment. Omega 3 fish oils naturally reduce inflammation so can bring down the swelling of inflammatory injuries like ligament tears. An omega 3 supplement that has potent anti-inflammatory effects is Lyprinol^®. Lyprinol^® comes from the New Zealand Green Lipped Mussel, Lyprinol^® is said to be 200 to 300 times more effective than other fish oils and flax seed. Lyprinol can give relief from other inflammatory conditions like joint pain and arthritis. Lyprinol^® is available from Whelehans.

 Arnica is a homeopathic remedy which has traditionally been used to bring down bruising, ease stiffness and swelling. Some studies have shown it can accelerate healing. Arnica tablets will work better for ligament tears than creams or ointments. Arnica may accelerate healing in injuries such as ligament tears. Other natural treatments for inflammatory type conditions are the herb Devil’s Claw and the natural supplement Glucosamine (which is actually found naturally in our joints). The effectiveness of these two supplements for ligament tears and other conditions is questionable. Whelehans stock a traditional remedy called “The Rub” based on a traditional Irish recipe of herbs passed down for over 100 years. It can give some relief when rubbed into the injured area; however like other alternative treatments mentioned above, it should only compliment conventional treatment.

Whelehans are delighted to announce our new Physiotherapy service. With sessions running in our private consultation room, the clinic is hosted by Sinead Brogan, our fully qualified Chartered Physiotherapist and certified STOTT pilates instructor. Reduced rates for over 60’s and sport clubs. Book a physiotherapy appointment by calling Sinead at 0831722171

This article is shortened for this Health Blog. More detailed information on high sprains is available in Whelehans or www.whelehans.ie

Whelehans Crew 2013

Whelehans Crew 2013

Difference between a chartered physiotherapist and a physical therapist

It could be asked, “are all ‘physios’ the same”? Unfortunately the answer is no. Unlike other medical professionals such as doctors, nurses, midwives and pharmacists, there is no protection in Irish legislation for the title of physiotherapist or physical therapist in Ireland. This means that in essence, anyone can not only assume such a title, but also practice under it.

 There are currently many therapists practicing in the Republic of Ireland in many different settings including sports and leisure using the term “physiotherapists”/ “physio”/”physical therapist” but who have not completed the required courses recognised by the only governing body in the Republic of Ireland called the Irish Society of Chartered Physiotherapists (ISCP). There is currently legislation being drafted by the Government which when finalised into law in the Dail will help clarify this situation for the public. In the meantime, you can protect yourself by ensuring when you require treatment with a physiotherapist; you always check that the person pertaining to be a physiotherapist is a Chartered Physiotherapist. A Chartered Physiotherapist will have the letters MISCP after their name.  This is your protection that you are being treated by a qualified practitioner.

 Ensuring your physiotherapist is a chartered physiotherapist is the only way of ensuring you have the most professionally trained physical health expert. By choosing a chartered physiotherapist, you are in the care of a healthcare professional with a university degree who has demonstrated the highest standard of excellence in clinical care. Chartered Physiotherapists are committed to continual professional development and education ensuring the most up to date knowledge and evidence for your care.

Why confusion can sometimes arise?

The confusion arises because in many countries including the UK and the US, the titles “physiotherapist” and “physical therapist” are protected, and may be used only by therapists with the appropriate qualifications such as four-year full-time degrees. In Ireland, however, physical therapists or sports therapists generally do not have the same qualifications as a physiotherapist, and often gain their qualifications through part-time programmes. To protect these titles and to protect the public, registration with the ISCP has become compulsory for physiotherapists with the appropriate qualification in recent years. This now means it is easier for patients seeking treatment to check if their physiotherapist has appropriate qualifications by simply checking if their physiotherapist is a Chartered Physiotherapist. A simple way of doing this is by going to the ISCP website (www.iscp.ie); by clicking on the section, “Is your physiotherapist chartered?” and when you type in the name of your Physiotherapist, if he/she is a Chartered Physiotherapist, it will confirm this as well as their county of practice. 

 What are the differences?

According to the ISCP, which accredits physiotherapists in Ireland, to be a member of the society and thus a Chartered Physiotherapist, physiotherapists must have completed a three- or four-year degree programme, either in one of four Irish universities or approved international university, as well as undertaking continuous professional development. This training includes three core areas of muscular skeletal, neurology and cardiorespiratory. By choosing a Chartered Physiotherapist, you are choosing a professional who has scientific approach to the assessment, diagnosis and treatment of your complaint. Chartered Physiotherapists are recognised and covered by VHI, Laya Healthcare, AVIVA and other health insurance schemes

A physical therapist, on the other hand, can complete a course on a part-time basis, from 15 months to a three- year term, so the levels of experience and qualifications do differ. Moreover, training for a physical therapist typically only focuses on muscular-skeletal areas and does not take into account other body functions and processes. While the work undertaken by a physical therapist may be legitimate, the ISCP argues that it is essential that the patient should understand exactly what experience and training the person treating them has obtained. Most physical therapists are very aware that they must communicate the difference between their qualifications and that of a Chartered Physiotherapist to patients.

 Only Chartered Physiotherapists are entitled to work in the public sector such as hospitals and health centres, thus it is in the private practice that confusion can arise. According to the ISCP, this grey area is leading to many problems, and it receives many complaints from members of the public who thought they were seeing a trained physiotherapist. Another issue is that there is less comeback when it comes to physical therapists. For example, if a chartered physiotherapist acts in an inappropriate manner or offers inadequate treatment, a complaint can be made to the society.

 Physiotherapy services are available at Whelehans Pharmacy, 38 Pearse St, Mullingar (Opposite the Greville Arms Hotel). Book a physiotherapy appointment with Sinead at  0831722171

Alzheimer's Disease

Dementia is an umbrella term used to describe various conditions which damage brain cells and lead to a loss of brain function over time. Dementia causes a progressive decline in a person’s mental functioning. It is a broad term, which describes a loss of memory, intellect, rationality, social skills and normal emotional reactions. The symptoms of dementia develop gradually over a period of years. The progression of these diseases is largely unpredictable for each individual.

Facts in brief
Dementia has a life changing physical, emotional and mental impact on the affected person and their primary carer and family. There are more than 100 conditions that cause dementia. While the risk of dementia increases with age, it is not a natural part of ageing. Dementia affects approximately one in 20 of people aged over 65 years. This rises to one in five in the 80 plus age group. While it is comparatively rare, dementia can affect younger people. There are approximately 3,800 people under the age of 65 with Younger Onset Dementia in the Ireland. A person with dementia will live for an average of four to eight years, depending on their age at diagnosis. Alzheimer's disease, the most common cause of dementia in Ireland, accounts for more than 50% of all cases; the second most common form is vascular dementia, which may be preventable.

Risk Factors

The risk factors for Alzheimer's disease include increasing age being female, family history, head injury, Parkinsons, hypothyroidism, exposure to dietary aluminium, cardiovascular disease, smoking and high alcohol intake

Health maintenance

As Alzheimer’s disease progresses, various conditions develop that may lead to death, such as septicemia, pneumonia and upper respiratory infections, nutritional disorders, pressure sores, fractures, and wounds. In the early stages of Alzheimer’s disease, health maintenance activities should be encouraged including exercise, the control of high blood pressure and other medical conditions, annual immunization against influenza, dental hygiene, and the use of eyeglasses and hearing aids as needed. In later phases of the disease, it is important to address basic requirements such as nutrition, hydration, and skin care.

Diagnosis

There is no straightforward test for Alzheimer’s Disease so diagnosis is difficult, particularly in the early stages. Diagnosis is usually made by excluding other causes such as infection, vitamin deficiency, thyroid problems, brain tumour, depression and the side effects of drugs which all can produce similar symptoms. Diagnosis involves a variety of medical assessments and observations. Assessment usually includes a mini mental state examination (MMSE). Specialists can only make a probable diagnosis. However, clinicians with experience in memory loss are able to diagnose AD to within 80-90% accuracy.

Medication

Medication can slow down progression of AD but is not a cure. Medication should be used in conjunction with non-drug treatment options. For more information on non-drug options, call into Whelehans or discuss with your GP. Four drugs are approved for treatment of dementia in Alzheimer’s Disease (AD) in the UK and Ireland. These are donezepil (ARICEPT^®), galantamine (REMINYL^®), rivastigimine (EXELON^®) and memantine (EBIXA^®). The first three are cholinesterase inhibitors and memantine is a NMDA receptor antagonist. All of these drugs must be started under specialist care. All these drugs now have less expensive but equally effective generic equivalents. These treatments can help improve a person’s memory and enable the person to retain new information for longer. The most common side effects are nausea, vomiting, diarrhoea and anorexia. These can be a particular problem because many people with AD loose weight. However,these side effects wear off after a few weeks in most people. 

Studies have demonstrated modest improvement in cognitive symptoms with cholinesterase inhibitors. Some studies demonstrated a beneficial effect for up to two years after starting treatment. There are no studies of longer periods of medication but most patients can expect that, in time, they will stop responding to treatment as the disease progresses. If the effect wear off, some prescribers recommend a ‘drug holiday’, for example the drug is stopped for six weeks and then started slowly again.

Donepezil has demonstrated in the short term (six months) a beneficial effect on mood and behaviour. Rivastigmine is licensed to treat dementia in Parkinson’s disease. Exelon 4.6mg/24hr transdermal patch and Exelon 9.5mg/ 24hr transdermal patch have been recently launched. The initial dose is 4.6mg/24hr for a minimum of four weeks, and if tolerated, can be increased to 9.6mg/24hr which is considered the recommended effective dose. The rivastigmine patch is considered to have fewer side effects than the capsule version.  Of the four drugs available memantine is the only one licensed to treat moderate severe AD.

There are no guidelines to recommend one drug over another. Donepezil and modified release galantamine only need to be taken once a day which is convenient. Rivastigimine and memantine need to be taken more often though memantine is often given as a single dose in the morning (ie) 2 x 10mg memantine tablets in the morning. There is also insufficient evidence to support the use vitamin E in AD. Further studies are required to test the benefits of Ginkgo biloba.

This article is shortened for this Health Blog. More detailed information and leaflets is available in Whelehans or check www.whelehans.ie

Eamonn Brady is a pharmacist and the owner of Whelehans Pharmacy, Pearse St, Mullingar. If you have any health questions e-mail them to info@whelehans.ie

LARCC extend their specialist post-breast cancer care services to Whelehans in Mullingar

To satisfy a growing local need, LARCC launched their new Breast Care Service here in the midlands region in 2008. Prior to this, women in the midlands who required breast care support services following breast surgery, had to travel to bigger centres like Dublin to obtain specialist breast care services such as prosthesis and bra fitting. LARCC’s confidential hassle free local service provides women with access to a comprehensive range of products and clothing through the support of qualified consultant fitters.

 Breast care service now open in Mullingar

LARCC are delighted to announce that in addition to offering their breast care services in the tranquil setting of their Multyfarnham headquarters, they are extending these support services to Mullingar. LARCC have teamed up with Whelehans Pharmacy in Mullingar to offer breast care support services in Whelehans purpose built and private consultation facility located to the rear of their Pearse St premises.  

 Eamonn Brady, owner at Whelehans explains that “this new service came about from feedback received from our customers who had fought breast cancer successfully and felt that it would be a great help to be able access specialist after care support services here in Mullingar. As a result of this feedback, I discussed the possibility with LARCC of extending their service to Mullingar”

 Eamonn continues “I feel that this service really fits with our ethos here in Whelehans. Our aim is to offer professional care and advice in a convenient local setting. We aim to offer the personal touch that you often find lacking in the world of multinational chains.  LARCC are renowned for the psychological and emotional support they provide to their clients. The homely atmosphere LARCC provide at their retreat and cancer care centre in Multyfarnham is unrivalled. The aim is to replicate this level of care and attention in a convenient town centre location.”

 The Team

The service is delivered by two members of the LARCC staff, a nurse and a therapist, who have both undertaken additional specialist training to become consultant fitters.

 The Service

LARCC’s breast care service at Whelehans will be the same service that LARCC offer in Multyfarnham. This includes on site consultation, breast form prosthesis fitting, bra measuring and fitting and discussion and support.

 Monthly clinic

The service in Mullingar will be offered via a personal private appointment at the monthly clinic held at Whelehans consultation facility. Telephone support and advice is also available from the LARCC team.

Products and services

LARRC offer the service to private and medical card clients. They offer a wide range of brands including Trulife^®, Amoena^®, Anita^®, Nicola Jane^® amongst others. The service is free for both medical card and private patients. Products are covered by prescription, medical cards and private insurance. In addition, LARCC offers all breast care clients the opportunity to partake of a variety of free therapies at their Multyfarnham retreat including massage, reflexology and reiki.

LARCC offer one hour consultations to each client, giving them plenty of time to try on a wide variety of stock, making sure they are happy and comfortable with their choice.

The breast care service in Whelehans Pharmacy is on selected Mondays. Lo-Call 1850 719719 to book an appointment. In LARCC’s Multyfarnham centre, the service is available on Mondays, Wednesdays and Thursdays every week.