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The Health Survival Guide

Minor Illness – The Pharmacist is Your Friend!

For all minor illnesses and ailments, don’t forget you can always ask the advice of your friendly neighbourhood pharmacist, who can advise you on remedies you can buy over the counter without the need for a prescription.
If you have a minor illness, you are able to go to a pharmacy and the pharmacists are able to assess you and advise you on further treatment. If the pharmacist thinks you need to be seen by a doctor or nurse practitioner then they will tell you. There is a Boots pharmacy on campus, under the university medical centre that will be able to cater to your needs.
All big named pharmacies (Boots, Superdrug, Lloyds) practice under the Pharmacy First scheme and will be able to see you for:

  • Urinary Tract Infection (known as Kidney Infection, Water Infection, UTI) for women over 18 only)
  • Conjunctivitis
  • Impetigo (not all pharmacies, so please ask)
  • Oral Thrush
  • Infected Nappy Rash

You can also speak to a pharmacist regarding any medication queries, medical or problems you think you have. If they cannot deal with it, they will tell you to see a doctor.
If you have ran out of your medication, and you are unable to get to the doctors, or we are closed – the pharmacy are able to give you an emergency supply until you are able to collect a prescription. This includes anti-depressants and Asthma pumps, but you will have to go to your regular pharmacy and it is down to the pharmacist which is there at the time so you may want to call ahead before dropping in.

Stress, Depression and Anxiety

I cannot think of anyone who has not experienced stress in his or her life. People can cope with huge amounts of stress and we all have different thresholds then this stress can start to make us feel unwell. It often doesn’t take one stressful event that you can put your finger on, but it can be a combination of things; uni deadlines and exams, relationships, housemates, family, childcare, ill health and these are things most of us will experience in differing amounts throughout our lives. Being at uni is without doubt a stressful time for all the above reasons and as you adjust to your own life often away from family.
Stress is undoubtedly the most important cause and consequence of two very common mental health conditions that are intimately linked; Anxiety (including panic attacks) and Depression.

Depression classically presents as a decrease in motivation and loss of interest in things you would normally be into that may or may not be accompanied by an all pervading sense of low mood. Appetite and sleep are often affected as well. You may find yourself under eating, over eating, sleeping less or sleeping more, typically with early morning waking.

Speaking of sleep being affected, have you ever struggled to get to sleep when you have an important exam looming or a big event in your life. Most of us have, but what about when this affects you every single night, what if this worry pervades your every walking moment? If you find your thoughts running away from you, all the different outcomes that may or may not occur? Sometimes when you feel this way, your heart can race, you can feel hot or faint or feel a sense of something terrible about to happen (panic attacks). If you’ve been feeling like this for any length of time, then you may be suffering from Anxiety.

If you’ve been experiencing any of these issues from stress all the way up to Depression and Anxiety then please don’t be afraid to come and speak to us. It’s not all about antidepressants though in some cases they can prove beneficial and we’re happy to discuss their use and debunk commonly held myths such as the belief that they are addictive.

The university runs one of the best, most integrated student support services of any university out there. They are based in the Roland Levinsky building and will quickly direct you to the services you need to support you through university life, be this financial advice, advice on how to maximise your studying potential, additional support you may qualify for and a complete counselling service.

Our next section links in with this one and explores the ways that our mental state can have a physical effect on our bodies.

  • Student Gateway – Your link to all the student services you need
  • Counselling – Self-help, E-Counselling, Workshops & groups, Cognitive Behavioural Therapy
  • Disability ASSIST – How the University can help if you have a physical or mental disability

There are also some services operated outside the university you may like to look at…

  • The Site – A great site that covers a huge range of health and social topics and a fantastic place to explore if the answers you’re looking for can’t be found in this survival guide or while you’re thinking about if you need to speak to us.
  • Plymouth Mind – a branch of the mental health charity Mind that helps support people with mental health difficulties and there is a great deal of useful information on their website.
  • Re-Think – a charity which provides a huge amount of information and support for people suffering with mental health issues, it’s well worth taking a look at their website.

Tired all the time? Strange Sensations? Under pressure? Stress, Mental health and the odd ways it can affect your body

People often think or assume that stress only affects the mind with conditions like anxiety and depression, but in fact stress affects our whole body. The same hormones and pathways in our nervous system that enable us to function form day to day can become essentially confused with lots of unusual physical symptoms across your body which, when put together, often don’t fit the pattern of a particular disease;

  • A thumping heart (palpitations).
  • Sweating and trembling.
  • Dry mouth.
  • Feeling tired all the time.
  • Hot flushes or chills.
  • Feeling short of breath, sometimes with choking sensations.
  • Chest pains.
  • Feeling sick (nauseated), dizzy, or faint.
  • Fear of dying or going crazy.
  • Numbness, or pins and needles.
  • Feelings of unreality, or being detached from yourself.
  • Needing to go to the toilet more often than before.
  • Symptoms get worse at times of stress and are less obvious or absent when relaxed

We of course need to look into these conditions to ensure there is nothing serious going on but we can usually perform some investigations within the space of 1-2 weeks that will tell us whether your symptoms are being caused by a disease or because of stress. If they are not found to be due to an underlying physical disease process, then we refer to the symptoms as Functional (since they affect functions within your body). The older fashioned term is “Medically Unexplained Symptoms” but as our understanding of the mind-body link grows, these symptoms become ever less unexplained.

You may have even been given a functional diagnosis in a previous practice or by a hospital specialist, but perhaps weren’t given a good explanation of the underlying causes? These functional diagnoses that follow are often known as a “diagnosis of exclusion”. That is, they have not met the diagnostic criteria for recognised physical or pathological condition that can be identified with all the modern investigations available to us in the 21st Century. Evidence shows that around 50% of referrals to hospital specialists involve functional symptoms. I have put the specialty that most often deals with each of these conditions in brackets next to them;

  • Irritable bowel syndrome (Gastroenterology)
  • Fibromyalgia (Rheumatology)
  • CFS/ME (Rheumatology or Immunology)
  • Non-epiliptic attack disorder (Neurology)
  • Dysfunctional breathing (Respiratory team)
  • Overactive bladder syndrome (Urology)
  • Chronic low back pain (Neurosurgeons, Rheumatology, Anaesthetics)
  • Temporomandibular Joint dysfunction (jaw pain and clicking, Maxillofacial team)
  • Atypical facial pain (Ear, Nose and Throat or Maxillofacial teams)
  • Proctalgia fugax (Fleeting pain in the bum; Colorectal team)
  • Globus Pharyngeus (feeling of a lump in throat; Ear, Nose and Throat team)
  • Tension headache (NeurologyChronic pelvic pain (Gynaecology)
  • Burning mouth syndrome (Ear, Nose and Throat team)
  • Tinnitus and hyperacussis (Ear, Nose and Throat Team)

These symptoms are often so distressing and feel so intense that it’s often hard to believe that there is not something seriously wrong with your body. In the vast majority of cases when we’ve ruled out anything serious through investigations, the conclusion is that your body is playing tricks on you. Once you understand that it’s your body playing tricks on you, you can take control of the symptoms. This will often require help from the doctors in the practice over a number of appointments, but that’s what we’re here to do so don’t be afraid to come and speak to us.

It’s a hugely complex topic so reading what’s above might not provide you with all the answers or reassurance. It’s for this reason that we’ve made the video below to explain things a bit better. If any of these points ring true with you then come and see us so we can help. It may well save you a lifetime of needless investigations throughout your life!

The university runs one of the best, most integrated student support services of any university out there. They are based in the Roland Levinsky building and will quickly direct you to the services you need to support you through university life, be this financial advice, advice on how to maximise your studying potential, additional support you may qualify for and a complete counselling service.

  • Student Gateway – Your link to all the student services you need
  • Counselling – Self-help, E-Counselling, Workshops & groups, Cognitive Behavioural Therapy
  • Disability ASSIST – How the university can help if you have a physical or mental disability

There are also some services operated outside the university you may like to look at…

  • The Site – A great site that covers a huge range of health and social topics and a fantastic place to explore if the answers you’re looking for can’t be found in this survival guide or while you’re thinking about if you need to speak to us.
  • Plymouth Mind is a branch of the mental health charity Mind that helps support people with mental health difficulties and there is a great deal of useful information on their website.
  • Re-Think is a charity which provides a huge amount of information and support for people suffering with mental health issues, it’s well worth taking a look at their website.

Coughs, Colds and Fresher’s Flu

Viruses are a fact of life and they are what causes the majority of the annoying illnesses we can all pick up throughout the year. You can expect to feel initially rubbish for a couple of weeks, but symptoms can go on for 4-5 weeks and the average length of symptoms is 3 and a half weeks. Longer than you thought eh?

Sadly there’s still no cure for the common cold and antibiotics don’t work on viruses as they’re designed to be used against bacteria, which grow and work in a different way. So what can we do I hear you ask?

  • Hydrate; yes it’s an old doctor classic “Make sure you drink plenty of water” but why do we say this? Simple, all the chemical reactions that allow us to function and fight off disease happen in a liquid environment, our bodies. When we have an infection, our body temperature rises and we lose more water through sweating and are more susceptible to dehydration. Plenty of water will also help flush toxins out of your body. It doesn’t mean you will get better that much sooner, but you will feel better for it!
  • Phenylephrine is a decongestant you find in cough and cold remedies and it does what it suggests it de-congests you, specifically your nose. A 10mg capsule should last 4-6 hours and you should take no more than 4 capsules in a day. Saltwater nasal sprays and washes can be really helpful in decongesting your nose as well. Sterimar nasal prays and Neilmed Sinurise are examples of these you can look up and buy at most chemists.
    -Paracetamol and Ibuprofen, as above, great pain relief and just what you need when your muscles and joints are all aching and you have a headache to boot.
  • Caffeine. Careful with the caffeine. It helps you stay up for when you’ve got to get work done and is a necessary evil when deadlines loom. The trouble is that it dehydrates you and if you have too much then you’ll have a terrible night’s sleep, exactly what you don’t need when your body is trying to get over a virus.

So we know that coughs and colds last about 3 and a half weeks. If you have any features of your cough, cold or ‘flu that you’re worried about or don’t fit in with your normal experiences of having them, then get in touch and we’ll answer any questions you have and do what we can to help!

Err I met this guy/girl…Sexual health

Don’t be embarrassed, sex is a fact of life, in fact it’s a prerequisite for life! But it’s not without it’s risks. Sexually Transmitted Infections are really common and it’s always best to play it safe. We all know though that in the spur of the moment that sometimes we don’t play it safe or even when we do, condoms can split. When this happens, don’t risk spreading STIs, get checked out at our Sexual Health clinic or head up to the GUM (Genitourinary Medicine) clinic at Derriford Hospital. Peverell Park Surgery (the other surgery at the UMC) also offers an STI clinic. Just call 01752 222341 opt 2 and tell them that you would like to book in with Peverell Park.
Remember you can have an STI without having any symptoms, so if you could be at risk, best to get checked out.

Good Night Out? Hangovers solved (maybe)

Hangovers (or veisalgia as we call it in the trade….no just kidding, I’ve never heard a real life doctor use the term veisalgia, I’ve literally only just learnt of it myself!), the bane that follows a good night out. We all know (or at least should do) that alcohol like anything is bad for us in excess; it contains lots of calories, affects our judgement, makes you feel more confident while in reality you’re coming across as an incoherent mess…sexy. But even the moral amongst us will have “one too many” and end up with the inevitable hangover. So what causes them and what’s the cure…is there a cure?! Please tell me there’s a cure! Here are the facts;

Despite how long we have been drinking alcohol as a species and the amount of time we’ve understood our bodies AND all the advances in that understanding in the last century…we’re still not very sure about what causes hangovers. We know the chemical processes and toxins which build up. Acetaldehyde is the first thing alcohol gets converted to by the body and is 10-30 times more toxic than Alcohol itself (depending on your genes). A variety of chemical reactions and hormone responses cause the feeling of being drunk…and yet blood tests to look at the levels of these over the years have found no correlation to the severity of hangover experienced.

What we do know is the more you drink, the greater the likelihood you’ll feel the sting of the hangover in the morning. We also know that alcohol is a diuretic (it makes you wee more), so although you’re drinking fluid that contains some water, you’re usually losing more than you take in over the course of an evening. We also know that water helps with everything in the body in terms of clearing out toxins. Our livers handle this process, and they’re pretty good considering they sort most hangovers out within a day. But livers and most body systems work best when they’re well hydrated. So the answer is: drink plenty of water before you go to sleep! It won’t clear your hangover but it will make it better.

Take home messages are by all means enjoy a drink if you’re that way inclined but be prepared to face the consequences the next day! If you’re worried about your drinking then have a look at some of the resources below or come and have a word with us in confidence.

And why is there no cure? Perhaps it’s because it’s a good safety mechanism to discourage us from drinking vast amounts of a toxic substance day after day. Our livers are only so good at handling alcohol and after a while they become damaged, and that damage can be irreparable, it’s why we ask about alcohol consumption.

“Upset Tummy”

Your guts are known as “the second brain” as they contain the second highest concentration of nerves outside the brain and central nervous system. No wonder it can become upset so easily! Often this is set off by either a virus going around or if you’re unlucky then from something you’ve eaten. Diarrhoea under these circumstances usually is self-limiting to around 3 days. The answer is again to rehydrate as you’ll lose lots of water in the process. You can also take Loperamide (you may know it by it’s brand name Immodium) as directed on the packet. If your symptoms persist for longer than expected then please ask to come and speak to us as we may need to arrange testing of your stool in the hospital labs to see if there if a particular bug that’s causing your symptoms.
If your symptoms persist for longer than 2-3 days or are feeling particularly bad from diarrhoea and vomiting then it’s probably time to call one of us so we can assess and advise you on what the next best steps might be. If you always seem to suffer from diarrhoea or alternating diarrhoea and constipation then there are lots of causes for this, but sometimes it can be as simple as day to day stresses. Like we mentioned above, the gut is the second brain and it responds to the same stress hormones as the brain itself. You may find the Tired all the time section helpful if that’s the case.

Handy Health Kit

Here are a few bits and pieces that it’s always worthwhile to have to hand. Most of the time you won’t need them but when you do and they’re not around you’ll regret it!

Where you can, keep things generic; by this I mean buy medicines under their drug name rather than trade name. You are gaining very little if anything by purchasing branded medicines and potentially losing a lot of money as a result!

What you’ll need:

  • Paracetamol
  • Ibuprofen
  • Phenylephrine
  • Loperamide
  • Iodine spray
  • Plasters/Spray plaster

All this for around £15. The tablets and capsules won’t last a huge amount of time but they’ll be enough to get you through a few days until you can get some more or if they’re feeling generous your house/flatmates can go out and get you some more!

And here are a few common ways you can put your shiny new health kit to good use should the need arise!

Pain Relief

In the words of REM “Everybody hurts sometimes”.

  • Paracetamol has been around for years and is very safe when taken at the recommended dose. If you’re in pain you can take 1g (usually 2x500mg tablets) every 6 hours (four times a day). Don’t be afraid to take up to this maximum dose.
  • Ibuprofen has anti-inflammatory properties so it’s particularly effective in treating pain associated with injuries. You can take 400mg (usually 2x200mg tablets) every 8 hours (three times a day).
    *Please note, if you suffer from asthma, there is a small chance that Ibuprofen can make the condition worse. If you have taken Ibuprofen before and it has not made your asthma worse, then you are fine. Feel free to discuss this with one of us if you have any worries or concerns.
  • ParacetamoI / Ibuprofen not working on their own? Not to fear, did you know you can take them together and it’ll have no ill effects?
  • If Paracetamol and Ibuprofen aren’t helping you with your pain then call up to speak to one of us so we can assess further and come up with a plan together. See our Out of Action section for more details of what you can do to help yourself if you’ve suffered and injury and what we can do to help you.

Out of Action? Sports, sprains, strains, crunches & cuts

The body is amazing, it can do so many things all at once without you having to even thing about it and given a fair chance it will heal itself just fine. How do we know this? Because I have yet to meet someone who has not at some point in their life had a cut, graze or pulled muscle that hasn’t gotten better on it’s own. There are however some things you can do to help yourself when injuries put you temporarily out of action.

If you have a cut that keeps bleeding then apply direct pressure over it, this slows the blood supply and allows clotting and scab formation to begin. In order to close a cut you can consider using wound closure strips as shown below (the guy faffs a bit so feel free to skip to the good bits, he does talk a lot of sense!) but if you’re not comfortable doing this then it’s getting to the stage where you may want to see one of our practice nurses or visit the Minor Injuries Unit.

Sprains and strains. I think a good starting point is to talk about what causes sprains and strains and how long you can expect them to last. Essentially any muscle or joint, which is overworked or over stressed repetitively, can become strained. It’s for this reason we always advise people to stretch out before undertaking exercise, common sense really. You may not notice this initially as it take a while for inflammation to set in (this is why people feel the effects of the gym the day after they’ve been). There’s a range of normality but generally when you’ve done something a little more than strain a muscle or joint, you know about it at the time. People often describe feeling a joint “go”. In this case there are a number of things that can happen. If the pain is unbearable with simple pain relief like Paracetamol and Ibuprofen or if the joint isn’t doing what it’s meant to do (eg. You can’t stand on your ankle or can’t raise your shoulder) then you should consider going to the Minor Injuries Unit or the Emergency Department to help rule out that you’ve not broken a bone.

But before heading straight up to the Emergency Department, have in the back of your mind the normal lifespan of a sprain or strain where you can still use the affected area (albeit with some discomfort). After the initial injury the pain will be at it’s worst in the first 24-72 hours. In this time there are things you can do to speed the recovery…RICE;

  • Relative REST of the joint/muscle (avoid aggravating movements/activities).
  • ICE the area by applying ice/frozen vegetables of your choice to the area (wrap in a towel or similar to avoid applying the ice directly to your skin).
  • COMPRESSION of the affected area with a bandage (depends on the area and how familiar you are with bandages, if you need help then consider going to the Minor Injuries Unit.
  • ELEVATION of the limb in question.

All these above measures will help to reduce inflammation along with taking Ibuprofen (provided you don’t have a medical reason that prevents you taking Ibuprofen), and will set you up for a swifter recovery. But how long will that be I hear you ask? As a rule of thumb, the worst of the inflammation and pain should settle within the first 2 weeks. In this time after the first 48-72 hours of RICE move the affected limb rather than keep it still otherwise the muscles and joints will stiffen and prolong your recovery. In order to hasten the recovery even more, then taking the body part through movements which reproduce the pain to some degree will send signals to the tissue encouraging it’s repair. This means not pushing your joint so far that it causes 100% pain as you’ll likely be re-injuring the joint. Instead a few times a day stretch and move the joint to 40-60% of the amount it takes to cause that 100% pain. In simple terms stretch until you feel some discomfort but not outright pain. You can help yourself with this by taking Paracetamol and Ibuprofen as outlined above in the Pain Relief section above.

You can reasonably expect the pain to be present for anywhere from 6-12 weeks if you take the measures outlined above. Sorry, I know it’s a long time but I didn’t make the rules up! This can be a really frustrating time especially if you’re in training for a particular event or season. We do recognise this and if you have special requirements then we can always refer you to the Physiotherapists and please do come and see us if your pain is getting worse or has not settled in 6-12 weeks. In the meantime, let’s introduce you to the Physiotherapists, they have a whole YouTube channel dedicated to exercises you can do at home to help you recover.

Smoking Cessation

If you’re trying to give up smoking, we can point you in the right direction.

Studies show that your chances of success will be greatly improved if you get advice and support from health care professionals to help you stop smoking.

The services offered at the local Seventrees Clinic just up the road from our main surgery can:

  • Boost your willpower to stop smoking
  • Concentrate your efforts by getting advice from someone who knows your medical background
  • Help you feel that you’re not doing it alone
  • Help you to cope when you are tempted to smoke
  • Monitor improvements to your health so that you can see the benefits

The Seventrees clinic is open from 8am – 6:30pm Monday to Friday and they will be able to arrange for a smoking cessation advisor to discuss things with you when you’re ready to stop smoking.

You may like to have a look at the ASH factsheet, particularly the “Increase in life-span” and “Health benefits after stopping smoking” sections if you’re still undecided on stopping smoking.

External Websites

For more information about quitting smoking visit:

  • No Smoking Day  – Information to help you to kick the habit.
  • Gosmokefree – This website contains detailed information about the free NHS support services.
  • Smoking Cessation – NHS Choices Site – if you smoke, giving up is probably the greatest single step you can take to improve your health.
  • Quit Org. – Quit is the independent charity whose aim is to save lives by helping smokers to stop.
  • Smoking Quitters Cost Tool – Calculate the money you will save with NHS Direct quitters cost calculator and plan how to spend it.
  • ASH – Action on Smoking and Health (ASH) is a campaigning public health charity that works to eliminate the harm caused by tobacco.

The Backup

The doctors and nurses at the health centre can help you with the majority of your medical and mental health needs, but there are limits to what we can do in the setting of the university medical centre. Sometimes we need to call in backup to provide specialist investigations, assessment, advice and surgery.

If the treatments we’ve tried haven’t worked and we foresee that you’ll need some extra help from someone who specialises in treating your condition then we will refer you to their service, which is usually based at Derriford Hospital.

There are also GPs with special interests (GPwSIs…we call them Gypsys) in a range of systems from skin conditions and musculoskeletal problems to heart conditions. They have close contact with the specialists in the hospital, can often see you sooner than a hospital specialist and you can usually be seen at a centre closer to town Cumberland and Mount Gould.

Once we’ve written your referral, it goes through a local sorting service (DRSS + LINK) to make sure you are seen by the person best suited to help you in the fastest time possible. You’ll hear through from the DRSS service by phone to arrange an appointment within 5 working days (waiting times for the appointment times themselves vary). Please make sure your mobile number and uni address are up to date, just pop in to update it with reception or with one of us during your GP or nurse consultation or else you could miss your appointment!

Anything else

If we’ve not covered what you were looking for in here then give the university health centre a call on 01752 222341 to speak to one of us and we’ll point you in the right direction, don’t worry we don’t bite!

Emergencies/What if the surgery is closed?

If you have an URGENT medical need when the surgery is closed, please see our ‘OUT OF HOURS’ page or call 111. Or if the problem is life threatening, call 999.
Many minor medical problems occurring after the surgeries have closed may be safely left until the next day, particularly with a little appropriate advice.

NHS Choices may be able to help online.

If you need to speak to a doctor call Devon Docs on 0845 671 0270. Your call will be recorded. If the doctor is unable to resolve your problem you may be asked to attend an emergency surgery.

In the event of a genuine emergency the nearest Accident and Emergency department is at Derriford Hospital on 0845 155 8155 or if the problem is life-threatening please dial 999.