9 June 2020 Millhouse Update 9
(June 2020 Newsletter)
Dear Valued Millhouse Patient
Day 17 without any Covid-19 cases is welcome news as we enter LEVEL 1.
Under lockdown levels 3 & 4, I zipped to work but now streaming cars clog the roads, especially around schools, and I wonder will we move to a greener environmentally-friendly pace or return to a pre-Covid-19 situation?
Last week, some told me of the uncertainty they now face after losing employment. Stress, sleeplessness, and anxiety are now commonplace. Please talk to a friend or family member or even the Millhouse Medical Team if you are struggling with problems that are becoming increasingly difficult to bear.
Remember the Wellness Support Programme, initiated by Counties DHB, that allows our doctors and nurses to provide support, at no cost, when you are experiencing mental health challenges and struggling with sleepless nights, anxiety and depression during this current crisis.
Telemedicine is the future for general practice, with an emphasis on phone and video as well as the continued importance of face-to-face consultations. Phone conversation is an effective and convenient means to review progress, initiate repeat e-scripts and follow-up e-lab forms. Another possibility is the establishment of e-Group sessions where those with similar conditions share and learn together.
Liquid Nitrogen is back and Saturday Morning Clinics, are again available.
Vaccinations - Flu shots are now available to all, with some limitations in supply, and Shingles protection is free for those over 65yr. Pneumococcal vaccination is free for those with immune deficiency disorders or those having cancer chemotherapy. This is especially recommended for those with chronic illness who have greater susceptibility to winter bacterial infection, but it is expensive. Please contact our Practice Nurse Team for more information.
Some have suggested the phone conversation should cost less than a face-to-face consultation. Both phone and face-to-face consultations are 15 minutes, and both require medical expertise and time, and so they are invoiced for the same fee. However, if as a result of a phone consultation, the doctor is concerned and wishes to see you in person that day, no additional fee is charged.
Medical certificates, scripts fees, and referrals will be invoiced and for other services that exceed 5 minutes a charge may apply.
Please include the chemist's full name and address, and whether they are a Unichem, Life or Warehouse pharmacy when asking for repeat prescriptions.
Many have told me how they look forward to the practical advice in these Covid -19 updates.
In the last update I spoke of the importance of the body's external barrier linings, which with the protective mucous and tear secretions which shore up our outer defences. If breached by foreign viral and bacterial invaders, the inner cellular innate immunity will fire into action. In a future article, I will discuss adaptive immunity, which comes into action when the innate immunity is overwhelmed.
In the table, I have summarised the nutrients that will keep the external and internal defences strong against Covid-19, other viruses, and bacteria this winter. If you develop flu-like symptoms, consider increasing Vitamin C intake, even to hourly, to accelerate the immune response. However do not exceed bowel tolerance, which would be indicated by loose motions and diarrhoea.
Exercise too has an important role in immunity and health.
In 2018 Professor Norman Lazarus with his colleagues from London University published a study on 75 long-distance cyclists aged between 55 and 79 years, who were compared with 55 non-active young persons. Blood results showed that the older cyclists' immune systems were as active at producing white cells to fight infection as the non-active 20-year olds' bodies and had lower levels of inflammatory proteins that accelerate the deadly Covid cytokine storm. Not only were their immune systems strong, but exercise had allowed them to maintain body muscle mass and strength, and not gain the weight associated with sedentary lifestyles. The photo shows study participant Robert Marchand at age 105, after he set a new one-hour cycling record. Most of us are not competitive athletes but we can still reap the benefits of exercise by getting moving, and stressing our body with regular exercise which causes us to get a bit puffed. In December 2010, I wrote 'I suggest when you exercise, for 30-60 seconds work as hard as you can. If you are walking go hard as you can between 2-3 lampposts, run as fast as you can up steps or a hill, perform push-ups or other exercises vigorously, sit in the chair and lift small dumbbells rapidly – I'm sure you can think of other routines'.
We were born to move, to be active and to exercise. Hippocrates in 400BC said that exercise is man's best medicine, but over time his message has been lost and we have increasingly become a sedentary society. Exercise is a panacea for our health problems – preventing weight gain, lowering blood pressure and cholesterol, improving diabetes and joint pain, enhancing energy, sleep and sexual function, as well as lifting mood, reducing anxiety, and relieving depression. Exercise can also be a fun group activity. Covid-19 advice suggests that the elderly are at greater risk of infection, as well as those with complex disorders, because the body's immune function deteriorates and we become more susceptible. But is that true?
Prof. Norman Lazarus
Remember that Millhouse is your 'health care home' and if you are lonely or anxious, or have any distressing symptoms, please ring our nursing team or make a phone appointment with your doctor.
Yours in good health,
Dr Richard J Coleman