What is Hay fever?

Medically known as seasonal allergic rhinitis, hay fever is a respiratory system disorder and common allergic reaction to pollen, with over 15 million sufferers in the UK alone. "...Over 15 million people in the UK suffer from hay fever..." Pollen is the fine powder produced by trees, grass, flowers and plants to fertilise other plants. When these tiny particles come into contact with the cells that line your mouth, nose, eyes and throat, they can irritate them and trigger the release of histamine which is an allergic reaction.

Hay Fever Symptoms can include:

  • frequent sneezing

  • Runny or blocked nose

  • Itchy, red or watery eyes

  • An itchy throat, mouth, nose and ears

  • Cough, caused by postnasal drip (mucus dripping down the throat from the back of the nose)

Although less common, you may also experience

  • The loss of your sense of smell

  • Facial pain (caused by blocked sinuses)

  • Headaches

  • Earache

  • Tiredness and fatigue

Depending upon the kind of pollen you're allergic to, you may notice symptoms at different times:

  • Tree pollen causes hay fever from March to early May

  • Grass produce pollen from late May to earlyAugust

  • Other plants can become your enemies as late as October

...While some symptoms may be less common and not as mild, they can interfere with your daily lives and activities such as work and school and disrupt your sleep...

Why does my hay fever sometimes get worse?

Hay fever symptoms are likely to worsen if the pollen count is higher.  Weather conditions affect hay fever symptoms as warmer sunshine causes more pollen to be released and higher wind conditions cause the pollen to be carried in the air further and faster.  On days in which the wind is low, it’s not as hot or days when it’s wet and rainy; your symptoms will improve as there is less pollen in the air.

Does everybody get hay fever?

No, but hay fever is likely to affect those with a family history of allergies particularly eczema or asthma.

What can I take to help with my hay fever?

If you suffer from any of the hay fever symptoms there is nothing to worry about as in most cases, you can get medication over the counter where you can also speak with a pharmacist who can advise on treatments for you or your children. If you struggle more than most however, and can’t control your hay fever symptoms with over the counter treatment then speak with your GP who can advise you further or other treatments.  

...Histamine is a substance released by the body in allergic conditions...

Treatments for hay fever symptoms include:

Antihistamines

Antihistamines treat hay fever by blocking the action of the chemical histamine, which the body releases when it thinks it is under attack. This prevents the symptoms of the allergic reaction from occurring. Antihistamines are usually very effective at treating watery eyes, itching and sneezing but may not be as effective when it comes to clearing a blocked nose. Over the counter Antihistamines include Benadryl, Zirtec and Clarityn. Dr Yasmin Conway advises that antihistamines can cause drowsiness and this is particularly the case with chlorphenamine (Piriton). The newer antihistamines cause less of this effect. If you suffer this side effect yuou should not take the medication if you are driving or operating potentially dangerous machinery.

Corticosteroid Nasal Sprays e.g. Beconase

If you suffer more with nasal symptoms, nasal sprays may be better for you as they have anti-inflammatory effect. When pollen triggers your allergic reaction, the inside of your nose becomes inflamed; corticosteroid can reduce the inflammation and help prevent the symptoms of hay fever. Theses sprays also tend to easy eye symptoms, although it is not clear how. Dr Yasmin Conway advises that it takes several days for these sprays to have a full effect. It can take up to 3 weeks in some cases so it is best to start to use them a few weeks before the hay fever season starts, if you are a regular sufferer. Remember to use the spray each day if you are a hay fever sufferer.

Decongestant Nasal Sprays e.g. Otrivin

Many hay fever sufferers will have nasal symptoms which include a blocked nose. Nasal decongestant sprays can help alleviate a blocked nose as they reduce the swelling of the blood vessels in your nose which helps open the in the nasal passage making it easier to breath. These can only be used for 5 days continually so are  best for people suffering intermittent rather than daily symptoms.

Eye Drops e.g. Opticrom

Eye Drops are available from you pharmacist to treat symptoms affecting your eyes such as itchiness, redness, and watering. These eye drops also contain antihistamine to help reduce the inflammation in your eyes, which will relieve the symptoms.

Grazax

This is a course of tablets containing grass pollen extracts. It is a form of immunotherapy exposing you to small amounts of the substance you are allergic to in order to reduce the allergy. Normally a specialist would initiate this treatment as the specific allergy must first be diagnosed with a positive skin prick test or blood test.

Tips for avoiding pollen:

The pollen count is generally given with weather forecasts. A high pollen count is above 50. During this time, it may help to:

  • Stay indoors with windows closed as much as possible

  • Avoid areas where grass is being cut and avoid large grassy areas

  • Consider wearing wrap-around sunglasses outdoors and even a pollen filter for your car

  • After being outside it is also worth washing your hair and showering

 

Don't let hay fever ruin your summer! Speak with your GP or book an appointment today on 020 7638 2999

Employee Healthcare and Benefits - Why is healthcare so important to a business and its employees and why do employees value this perk so highly?

Employee healthcare and benefits have become an important part of a company’s strategy when securing the best possible talent to help their business grow. But of all the benefits offered, why is healthcare so important to a business and its employees and why do employees value this perk so highly?

Typical benefits can include a whole list of services from cash plans, gym memberships, healthy eating promotions, pensions and insurance as well as health screening and promotion.  Benefits are a great thing to offer new as well as existing employees and can be part of an employer’s long-term approach to improve the productivity and engagement of their staff. Of all these benefits however, workplace health promotion and yearly health screens tend to be received by employees far better than most. 

"...Employers who implement a comprehensive set of strategies to address employee health and safety benefit by having the ability to reach most if not all employees at the work-site simultaneously…"

For employees, the maintenance of their own individual health is often seen as a difficult challenge a midst the demands of the working day, family responsibilities, and other social obligations. However, adopting healthy behavior not only reduces the risk of developing disabling or life threatening diseases with their associated costs, but improves everyday quality of life

 In a recent survey, 77% of employees responded that “health and wellness programs positively impact the culture at work. 

Participation in health promotion activities through a workplace health program allows individuals to develop knowledge, self-management and coping skills. Employees often see a comprehensive workplace health program as an investment made by their company for their own well-being and a reflection of how much the company actually does care about them and other employees…this just might impact on job satisfaction and morale.

Employers can also benefit from workplace health programs through enhanced productivity, decreased employee absenteeism, and even lower insurance and workers compensation costs. These strategies help create a culture of health and make the healthy choice the easy choice for employees. 

In addition, workplace health programs are increasingly seen as a core component of attractive employee compensation and benefits packages. This can be used as a recruitment and retention tool to attract and keep high quality employees and maintain not only morale and job satisfaction but also productivity.

  • Employees in good health are 3 times more productive than employees in poor health
  •  Healthy employees are able to concentrate more on their jobs and the make 60% fewer errors than employees in poor health
  • If an employee will exercise at least once a week, they will reduce their average number of sick days from 10 to 5
  • 87% of employees consider health and wellness benefits when choosing an employer

"…The wellness and well-being perk has become an important part of company healthcare and sickness absence strategies and recruitment…"

What is Multiple Sclerosis?

Multiple sclerosis (MS) is a neurological condition caused through the build-up of scar tissue to the myelin sheath, the material that surrounds and protects your nerve cells, in the brain and/or spinal cord.  This damage slows down and blocks the messages between your brain and body resulting in the in the loss of muscle control, vision, balance, and sensation leaving many sufferers feeling numbness, pins & needles and tightness in the chest. MS affects around 100,000 people in the UK, with diagnosis being made to people between the ages of 20 – 40; it affects approximately three times more women than it does men. No one knows what causes Multiple sclerosis but we do know that sufferers are not born with it.  

Are there different types of MS?

Yes. MS has four primary forms. The most common form is called -

Relapsing Remitting MS (RRMS).

People with this form of MS tend to have attacks of which the symptoms then fade either partially or completely. This form of MS affects approximately 85% - 90% of sufferers. Other forms include -

Primary-Progressive MS (PPMS)

Progresses slowly yet steadily from the beginning. Symptoms stay at the same level of intensity without decreasing, and there are no remission periods. Sufferers of PPMS tend to experience a continuous worsening of their condition.

Secondary Progressive MS (SPMS)

The form that follows RRMS. SPMS sufferers worsen from relapses without tending to recover leading to the build-up of disability. On average, around 65% of people with relapsing remitting MS will develop secondary progressive MS 15 years after being diagnosed.

Progressive-Relapsing

Progressive-Relapsing is a relatively rare form of MS. People experience their condition as steadily worsening, yet also experience clear relapses in the form of acute flare-ups. In some cases, there is no recovery from these flare-ups, although in other cases there is recovery. The difference between progressive-relapsing MS and relapsing-remitting MS is that in the former type, the periods between relapses involve continuing progression of the disease.

What are the Symptoms of Multiple Sclerosis?

Symptoms of MS can vary from person to person and can even change over time. The most common early symptoms include:

  • Muscle weakness
  • Decreased coordination
  • Pain behind the eyes
  • Blurred or Double vision

As the disease progresses, symptoms can further develop causing muscle spasm, difficulty controlling urination, or problems with cognition. MS is usually a mild disease but in some cases people can lose the ability to write, speak or even walk.

What are the stages of Multiple Sclerosis?

MS affects everyone differently so there is no way of identifying the particular stages a sufferer will go through.  Some symptoms of MS in people can be far more severe than in others. Some may be mild, brief, or long lasting and can appear in various combinations.

What are the tests for Multiple Sclerosis?

There is no single test for MS. Doctors use a medical history, physical exam, neurological exam, MRI, and other tests to diagnose it. There is also no cure for MS, but medicines may slow it down and help control symptoms. Physical and occupational therapy may also help.   MS can be a challenging and frustrating condition to live with but new treatments over the past 20 years have considerably improved the quality of life of people with the disease. If you’re worried or want to speak with someone about MS you should speak with your GP who will be able to give you further advice.  

Acute stress, Episodic acute stress and Chronic stress and Post-traumatic Stress

Recent statistics show that 1 in 5 employees are stressed. But, what is stress? Is it just related to work and how can you cope if you’re feeling it? Everybody feels stress but very few think about what stress actually is and how it can really affect us. Stress can be a negative or positive condition that has an impact on a person's mental and physical well-being.  Stress is our body’s response to specific situations and there are many different symptoms associated with stress and stress itself can fall into four categories -

  • Acute stress

  • Episodic acute stress

  • Chronic stress

  • Posttraumatic stress (PTSD)

Acute stress

Acute stress is the more common form of stress and is associated with things to do with our everyday lives such as losing bills, rushing to meetings or making deadlines. These kinds of demands and pressures tend to be short term stress related issues that don’t have time to do any damage that long term stress could. Acute stress can actually be exciting and thrilling but too much can make you feel exhausted. Symptoms of acute stress can include emotional anguish, headaches, back pains and general muscular problems. They may also include irritable bowel syndrome (IBS), dizziness, and shortness of breath and chest pains and heart palpitations which can often be triggered by adrenaline.

 Acute stress can affect anyone but it is very manageable.

Episodic Acute stress

Episodic acute stress is the stress which affects those who suffer from acute stress more frequently. People that tend suffer from this always seem to be in a rush, They take too much on and tend not to be able to organise themselves to deal with demands and pressures. Episodic Acute stress can affect interpersonal skills and can make sufferers hostile towards others causing a deterioration of relationships at home and the workplace. Its symptoms include prolonged over stimulation, persistent tension, headaches or migraines, hypertension and chest pains. Episodic acute stress can be helped with certain lifestyle changes but professional help may also be needed before any chronic problems develop.

Chronic stress

Chronic stress is the stress that can wear a sufferer down making them feel “burned-out”. Chronic stress is stress that someone can feel when they can’t see a way out of the demands and/or pressures that are making them feel depressed, miserable and disheartened on a continual basis. Factors of chronic stress can be the feeling of being trapped in an unhappy marriage or career and tends to be associated with ill health, alcohol excess, violence and can even be associated with suicide. Chronic stress can be helped with professional and medical help such as special forms of counselling and targeted behavioural therapy.

Post-traumatic stress disorder (PTSD)

Post-traumatic stress (PTSD) is the stress associated with frightening or distressing events. These can be traumatic experiences from someone’s childhood, wars, poverty, sexual or violent abuse. Sufferers of PTSD tend to feel on edge and can relive traumatic events through nightmares and flashbacks. They struggle with concentration and have trouble sleeping. Sufferers can have strong feelings of guilt, emotional numbness, constant worry and depression. Symptoms associated with PTSD can often be very severe and have a huge negative impact on a person’s day to day life. (Through the depletion of physical and mental attrition).   Stress is not always bad nor is it the same for everyone.  There can be different symptoms for different people all of which should be addressed early on. If you’re beginning to feel stressed, it’s good to try and make adjustments to your lifestyle such as designating times to be active, becoming more social and safeguarding relaxation time. Watch out for the physical symptoms of stress such as persistent headaches, muscle tension, irritable bowel symptoms and insomnia. If these develop, speak with your GP and get advice and don’t be afraid to talk about. Further information on stress can be found on: HSE Mind NHS Mentalhealth.org  

Facts about the menopause

Immediate menopausal symptoms can include hot flushes, night sweats, vaginal dryness. These are definite symptoms of oestrogen deficiency. Other symptoms may include irritability, depression, poor concentration and forgetfulness, lethargy, loss of confidence and aching joints. Although these symptoms often occur around the time of the menopause, if they do not respond to HRT then they are probably not caused by oestrogen deficiency and further investigations may be required. The menopause can have more long-term effects. The loss of oestrogen can lead to a hardening of the arteries thus increasing the risk of heart attack or stroke. It can also cause osteoporosis (brittle bones) in some women.

Hormone replacement therapy?

Hormone replacement therapy (HRT) aims to replace the female hormones that are lacking in the body after the menopause.  It aims to reduce the symptoms of the menopause (see above) both in the short and long-term. There are three basic types:

  • Oestrogen – for women who have had a hysterectomy
  • Oestrogen plus progesterone – for women with a womb
  • Tibolone – for women who have had at least 12 months without natural periods.

There are many methods of administration – tablets, skin patches, run-in gels, vaginal pessaries, cream, or as a pellet implanted under the skin every few months.

Starting HRT

You can start HRT as soon as you experience symptoms of oestrogen deficiency. Treatment is sometimes not commenced until after a woman’s final normal period but it may be started before this if symptoms are particularly troublesome.

When HRT is not recommended

It is generally not a good idea to give HRT to a woman who has had cancer of the breast or endometrium (lining of the womb) as these tumours are oestrogen dependent. However, if such a woman has very severe menopausal symptoms which make her life intolerable then, providing she accepts the risk, HRT may occasionally be prescribed. A previous history of a blood clot, high blood pressure, smoking and obesity are not absolute contra-indications to HRT but they may influence the chosen route of administration. Possible side effects Tender breasts, nausea, leg cramps, fluid retention and mild abdominal bloating. There is NO significant weight gain.

Alternatives to HRT

Some drugs treat individual rather than collective aspects of the menopause eg Clonidine controls the hot flushes and night sweats and raloxifene protects bones against osteoporosis. Natural products such as vitamin B6 and evening primrose oil have helped some women with a number of menopausal symptoms. Some alternative therapies may help with some of the symptoms (reflexology, aromatherapy and acupuncture) but these treatments have not been medically proven and should be discussed with your doctor.

HRT : Some common questions and our answers

What regular monitoring and check-ups should I get on HRT?
We recommend 6 monthly checks of weight and blood pressure and a pelvic and breast examination every year. It is also recommended that all women over the age of 50 should have a mammogram and a cervical smear every 2-3 years whether or not they are on HRT. In addition if there is a history of cancer in a near relative (e.g. mother, sister, grandmother) it is probably better to have a mammogram annually and to consider starting mammography earlier. We also strongly urge all women to practice self-examination of their breasts.

Will HRT make me fertile again?
No. The menopause indicates cessation of ovarian function and therefore an inability to conceive. However, women who commence HRT before their natural periods finish are advised to use contraception until their early 50s.

After nine months on HRT I am still getting symptoms. What can I do?
There are 3 possible reasons for this. 1.    You may not be receiving enough HRT to control your symptoms; this is usually solved by increasing the dosage. 2.    You may be on the wrong type of HRT. Some women who take HRT tablets do not absorb them from their gut and therefore no active hormone reaches the blood stream where it is required to be effective. Such women usually improve when treated with either a hormone patch or an implant. 3.    Your symptoms may not be due to oestrogen deficiency at all (see “Facts about the menopause”).

My GP gave me six months supply of HRT, then stopped. Why? and what will be the consequences?
Unfortunately despite growing research into HRT and continued publicity there still seems to be a lot of confusion about the safety and benefits of long term HRT. The duration of menopausal symptoms (untreated) varies tremendously from woman to woman; they usually continue for at least 2 years and often last for considerably longer. Therefore stopping treatment after only 6 months will usually result in their recurrence. It is particularly important for women who are at risk of developing osteoporosis to take HRT for at least 5 years to get proper protection for their bones. As long as women undergo a regular medical check-up, practice breast self-examination and remain healthy there is no reason why HRT should suddenly be stopped after 6 months.

Will HRT help my sex drive during and after my menopause?
There are many reasons why women lose interest in sex at this time. However, HRT relieves vaginal dryness, a cause of painful intercourse, and consequently may reawaken your interest in sex. If after treatment with oestrogen your libido (sex drive) is still low then a small dose of the male hormone, testosterone is often helpful. However this is only available as an implant.

Is there any increased risk of cancer on HRT?
Although it is the oestrogen which produces all the positive benefits of HRT for a woman who still has her uterus (womb) it is important that she should take a small does of progesterone for a part of each month to protect against endometrial (womb) cancer. Providing a short course of progesterone is taken each month there is no increased risk on endometrial cancer. The effects of long term HRT on breast cancer risk are very controversial. With the low doses of hormones used on HRT there appears to be no increase in risk of breast cancer with up to 5 years of treatment. There may however be a slight increase in risk of breast cancer if HRT is taken for 10 years or more. However, not all studies have reported this; some have observed no increase in risk even with long term treatment. There is no evidence at present that HRT changes the risk of cancer of the ovary or cancer of the cervix.

Before starting HRT do I need any tests to check my hormone levels?
Not usually. Obvious menopausal symptoms such as hot flushes indicate low oestrogen levels and therefore no tests are necessary. Sometimes where there is some doubt as to whether symptoms are menopausal in origin a blood test may be carried out but even here a short trial of HRT may be undertaken. Blood tests are also sometimes taken in cases of suspected early menopause to confirm the diagnosis.

What is osteoporosis and how can HRT help to prevent it?
Osteoporosis literally means porous or brittle bones. It affects one woman in four (compared to one man in twenty) and develops over a period of years after the menopause. It is now known that bones are dependent on oestrogen and it is therefore very important, especially for women who are at increased risk of developing the disease (see below), to take HRT for a minimum of 5 years. It has also been shown from research that bone is lost at a greater rate during the first 2 to 3 years after menopause than in the following years. Therefore HRT should be started sooner rather than later.

Am I susceptible to Osteoporosis? 
All post menopausal women are at risk of osteoporosis and there is no simple way of telling which women are at increased risk. However, your risk is greater if you fall into any of the following categories: •    Thin, fair skinned, small boned •    Early menopause (before 45) •    If your mother or grandmother lost height because of bone fractures •    If you smoke •    If you have regularly consumed more than two alcoholic drinks per day Black people have a much denser skeleton than white people and therefore their risk of developing significant osteoporosis is reduced. One final comment: HRT can only arrest the process of osteoporosis, it cannot put backbone which has already been lost.

Do oestrogens change the risk of heart attack and stroke?
Numerous studies conducted in the USA have reported that HRT reduces the risk of “furring up” the major arteries in the heart and lower the chance of heart attack. Similar results are now becoming available for arteries in the brain with a reduced risk of stroke. These arterial diseases are the most common cause of death in women aged over 50 years and are much more common than breast and endometrial cancer. Most of the studies from the USA were conducted in women taking oestrogen by itself. It is not known whether combined HRT (oestrogen plus progesterone) has the same beneficial effects.

Can older women benefit from HRT?
Maximum benefits are derived from HRT by starting as soon after your menopause as possible, particularly for bone protection. However, even starting treatment many years after your menopause will maintain your existing bone thickness for as long as the treatment is continued. Many women who start HRT later on in life find they get other benefits. They feel more lively and sleep better and are less likely to be troubled by vaginal dryness. However, it is important to remember that HRT will usually lead to a return of a monthly bleed. The vulval and vaginal area of older women often becomes very dry and sore and short intermittent course of oestrogen cream can often relieve these symptoms and may reduce the feeling of constantly wanting to empty the bladder.

Can I have too much HRT and will it do me any harm?
Your body will alert you to oestrogen overdose by certain symptoms such as tender breasts and nausea. Although these symptoms are common they usually settle down after a few months.

Do I need HRT after a hysterectomy if I still have my ovaries?
So long as you were having periods before your hysterectomy (i.e. your ovaries were working normally) you will not need HRT. However, it is recognised that women who have undergone hysterectomy often develop menopausal symptoms at an earlier age than those who have not, and these women obviously need to start HRT earlier.

My hair is falling out and my skin is dry. Will HRT help me?
The relationship between oestrogen and hair is poorly understood at present. Hair loss is more likely to be age dependent, whereas dry hair may be due to oestrogen deficiency. Similarly, dry skin sometimes improves with HRT.

What can I do about incontinence?
This is a common female problem, especially in later life, and is often triggered by a sneeze, cough, laughter or playing sport. There is some evidence that some types of incontinence may be helped to some degree by HRT. Pelvic floor exercises may also help. These are done by tightening the muscles as if you were trying very hard to hold back your urine. Tighten, hold and relax at least 25 times on each occasion. Also, try to stop your flow of urine mid-stream. If there is no improvement despite HRT and exercises, you should see your doctor again.