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7 February 2011
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Dr Jonty conducts an open surgery in Birmingham

Our four GPs hit the streets of Birmingham for an urban open surgery to offer their skills and expertise to anyone they meet.

Dr Ayan meets Lucy who is desperate for a good night's sleep and missing out because of cramp in her left foot. She has had cramp for some time now so Dr Ayan gets her to take off her shoe and offers this advice: make sure you drink plenty of water and try quinine, a medicine that is quite good at treating cramps. Quinine is also found in tonic water.

Dr George is at Birmingham Symphony Hall where the orchestra is about to host a concert for 2000 excited children. However the lead violinist Andrew is struggling with shoulder pain. Dr George suggests he does some stretching exercises before and after his performance, just like an athlete. In bringing his arms up behind his ears, Andrew may look like a contortionist, but he'll be releasing the pressure from the neck and the shoulder area. If he repeats the action five or six times before and after a concert performance, it will relieve the pain.

Dr Jonty and Dr Ayan next meet Marie, a woman in her seventies. She was in a car accident 20 years ago which hurt her spine slightly. At the time an osteopath straightened her up. However it went again recently when she tried to cut a tree down. This means she can no longer enjoy her favourite pastime, dancing. The doctors are concerned she may have a crack in one of the spinal bones and advises her to get it x rayed at a local hospital. Like most women of her age, Marie is also susceptible to osteoporosis, a thinning of the bones. The key thing is to get Marie dancing again, a pastime she loves, and a great, fun way to exercise.

Meanwhile Dr George is fine tuning trombonist Alwyn. He has a sore foot, a problem not helped by standing up all day and being overweight. The tightness and cramp in his toes is probably due to metatarsalgia. Dr George points out that a metatarsal support will help as it will offer even weight distribution right across the base of the foot. However without losing a considerable amount of weight it simply will not work.

In the city centre, Dr Jonty meets Sandra who is worried that blood from her back passage may indicate bowel cancer. Dr Jonty proposes two things. First Sandra must visit her GP since an examination on the streets of Birmingham won't do. The second thing is to take a quick blood sample to make sure Sandra's not anaemic. If she is anaemic then that would require more urgent investigation.

Back at the concert hall Dr George meets Gabby who has travelled up from Watford and is feeling car sick. Travel sickness is due to the balance mechanism within the inner ear getting disturbed by the motion of the car. Dr George advises certain anti histamines from the chemist should settle the nausea and prevent any sickness. It takes about an hour to work but means that Gabby should have a sick free journey back to Watford later in the day.

If you want to avoid car sickness here is Dr George's advice: don't eat big meals before or during a journey, sit in the front seat or elevated so you have a clear view of the road, open the windows, look at objects in the distance or better still close your eyes and try to sleep.

Meanwhile Dr Ayan's on his way to see Marie with the results of her X-rays. Her results show no fracturing of the spine but they do indicate a slight thinning of the bones, pointing to osteoporosis. This is not unusual in a woman of Marie's age and Dr Ayan suggests it might be an idea for her to start taking some calcium supplements as calcium can strengthen the bones. Most importantly Marie should be able to take up dancing again soon.

At Birmingham's bustling indoor market Dr Barbara meets Zack who suffers from headaches. These get worse as the day wears on. Often the most common causes of chronic headaches that worsen throughout the day are stress related. Dr Barbara checks Zack's blood pressure and while a first reading is high, a second, taken while Zack is sitting down and feeling relaxed, produces a much lower reading. Simply relaxing and reducing his stress levels has brought it down.

Dr Ayan meets Sandra once more to reveal her blood test results. Sandra is worried about bleeding from her back passage and the tests show that her red blood cells are smaller than normal showing the first signs of anaemia. Sandra needs a rectal examination to rule out bowel cancer but Dr Ayan points out that there is another condition that could cause the bleeding, diverticulosis. This can develop as a result of severe constipation. So it could be that Sandra has something like this but again a test would be needed to confirm it.

Bowel cancer is more successfully treated if diagnosed early. Symptoms include blood or mucus in your stools, change in bowel habit, tiredness and weight loss. If you're concerned see your GP.

At the end of a busy day Dr Jonty's last patient is bell ringer Rod. He has an enlarged prostate which means he often has to rush to pass urine at short notice. Dr Jonty advises that there are medications available that do shrink the size of the prostate quite successfull. However, this is something you should discuss with your GP. If that doesn't help the next step is to think about an operation which will shave away at the enlarged prostate. It is important to check on the size of the prostate with your GP to make sure there are no changes in it that might indicate cancer.

If you're worried about an enlarged prostate, there are some key symptoms to watch out for: passing urine more frequently, getting up in the night to urinate, difficulty starting the flow of urine and a reduction in the force of your stream of urine. If you're concerned see your GP.

At Birmingham's snow dome Dr George's final patient has a pain in her right ear. Dr George reassures her that it is more a collection of fluid in the middle ear. One option would be to go to a pharmacist and get decongestion nasal drops and after three or four days the problem should clear up.

Related Links

National Osteoporosis Society
A comprehensive source of information on osteoporosis, detailing treatment approaches and prevention measures.
Highly informative site, offering support, authoritative answers to pressing questions, details and diagrams about different types of cancer and treatment information.
Cancer Research UK
Provides an informative overview of the commonest cancers, alongside details of preventative measures that you can take.
Macmillan Cancer Relief
Guidance on cancer treatment and care, with equal focus for sufferers and those with affected relatives.

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Dr Ayan

Health Tips

from Dr Ayan

  • Eat five portions of fruit and veg a day.
  • Drink plenty of water, eight glasses a day for an adult.
  • Exercise is crucial. Twenty minutes minimum, three or four times a week.
  • Avoid stress by managing your time better. If you leave everything to the last minute then it creates stressful situations.

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