Our four GPs hit the streets of Cardiff this week for an urban open surgery to offer their skills and expertise to anyone they meet.
In the city centre Dr Ayan meets Neil, a town crier who has a strained elbow, aggravated because he swings a bell all day. Dr Ayan diagnoses tennis elbow and suggests a mixture of physiotherapy and anti-inflammatories like ibuprofen to relieve the pain.
Dr George is back at school where he meets a dinner lady with lower back pain. Terri admits she is overweight and Dr George agrees that this won't help. He demonstrates a series of simple stretching exercises that should help relieve her pain.
If lower back pain is troubling you, Dr George recommends you take pain killers, keep active, and if the pain continues, consult a physiotherapist.
At Cardiff's historic castle Dr Barbara meets a tour guide suffering from gout. Four years ago when it first flared up, Graham experienced sudden burning pains in his ankles and the joints of his hands.
Dr Barbara explains that gout is a deposit of uric acid crystals in the joints, which causes swelling and redness. Some sources think that it's associated with eating too much red meat and Graham agrees, he does eat a lot of meat and drinks at weekends.
If you drink alcohol you do tend to become dehydrated and this can make the gout worse. For gout sufferers it is important not get dehydrated and to cut down on red meat.
At Evergreen Tennis Club Dr Ayan meets Neil who has a groin injury. Dr Ayan examines the area and is pleased to report that Neil does not have a hernia. However he is concerned it may be arthritis of the hip and suggests an x ray to find out.
At Cardiff Bay Dr Jonty meets Amanda who has a persistent cough. She used to suffer from asthma but hasn't needed to use an inhaler since 2001.
Dr Jonty checks her peak flow which is a little lower than it should be and suggests she inhales some salbutamol to boost it. The salbutamol immediately produces positive results which lead Dr Jonty to believe that Amanda has had a viral infection and this has set off her asthma. He suggests she starts using an inhaler again until the cough has cleared up.
Amanda's condition is not unusual in Cardiff - Wales has one of the highest incidents of asthma in the world.
Back in the city centre Dr George meets 46 year-old Bev who is concerned that her increasingly erratic periods could mean she is about to start the menopause. Dr George points out the menopause can start at any time between 35 and 55.
He suggests Bev take a blood test which will check her hormone levels and indicate if she is indeed menopausal.
Dr Jonty has left Cardiff and travelled to the last working mine in Wales, Tow Colliery. He meets Damian who works at the coalface and is suffering from a bad knee.
Dr Jonty examines Damian and is pleased to note that there is no swelling or fluid on the joint. What Damian does have is some tenderness in one of the ligaments on the side of the knee. Clearly Damian's line of work isn't helping. The best course of treatment is rest, a support bandage and anti-inflammatories. He can also get creams that have anti-inflammatories in them.
Meanwhile Dr Ayan meets again with Bev to go through the results of her blood test.
Her results show she is not menopausal but the symptoms she is showing such as mood swings, headaches, and hot flushes would indicate she is approaching the menopause. This would explain hormone level changes and the fact that her periods are becoming irregular.
Dr Ayan recommends black cohosh, a plant extract that comes from something very similar to the buttercup. Native Americans use it regularly as it evens out the hormonal imbalance.
If you're approaching the menopause Dr Ayan advises you take regular exercise to keep bones and muscles strong, cut down on alcohol and cigarettes as they can aggravate symptoms, and talk to your GP about the possibility of hormone replacement therapy.
Back on the city's streets Dr George meets a long distance runner with a fungal infection on his feet. Dr George recommends he take a particular tablet, keratin, which should clear up the discoloured nails. He warns, however, it may take up to two or three months to work.
At Cardiff Bay Dr Jonty gives advice to Linda who suffers from panic attacks. These have become so severe she has had to stop driving.
When people have panic attacks they tend to hyperventilate and Dr Jonty suggests some simple solutions. Sit quietly and concentrate on your breathing. Try occupying your mind and don't focus on the dizziness. One of the best techniques is to keep talking and remember the symptoms are not life threatening, they do pass.
At a local crisp factory Dr Ayan has set up a shop floor surgery and meets Stephen who has a lump on his back. Dr Ayan takes a look and suggests it is either a collection of fluid, called a ganglion, or a collection of fat called a lipoma. Either way it is absolutely nothing to worry about. If it gets really big or painful Stephen could have it removed, but until then Dr Ayan would advise to leave it alone.
At the Cardiff Male Voice Choir Dr Barbara has also found a lump; but this time there's more cause for concern. David has a lump on the side of his neck and over the last year has lost a lot of weight.
An enlarged gland may be the result of an infection and if this is the case antibiotics can bring it down.
However, Dr Barbara is concerned by David's weight loss and stresses it is vital for him to have it biopsied or scanned.
Finally Dr Ayan meets again with Neil to give him the results of his x ray. It indicates that he has transient osteoporosis brought on by playing tennis. The condition is curable and Dr Ayan suggests he give up the sport for four to six weeks and rest. This won't be easy for Neil but he promises to do his best.
- Arthritis Research Campaign - Gout
- Excellent information, comprising symptoms and treatment, plus a look at possible dietary causes and preventative measures.
- Spine Universe
- This US site covers an astonishing range of back conditions and diseases, surgical and non-surgical treatments, pain management and recovery advice.
- National Asthma Campaign
- Excellent resource of information, with a Kids' Zone aimed at helping children cope with the condition.
- NHS Direct - Menopause
- Advice and facts on the physical and emotional aspects of the menopause.
- National Phobics Society
- A society working to relieve and support those living with anxiety disorders by providing information, support and understanding via an extensive range of services.
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from Dr Jonty
- Drink alcohol in moderation and have at least two drink free days a week.
- Spend half an hour a day doing something that makes you feel relaxed. Try meditation.
- Stop smoking and use the money you save to treat yourself to a massage.
- Get at least 7- 8 hours sleep a night.