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Daily Archives: May 12, 2015

COUGH – WHEN TO SEE THE DOCTOR WITH YOUR CHILD

Cough is the commonest reason for preschool children to see a GP. Isolated coughing has been reported by parents in almost a third of children at any one time; the symptom can have an impact on sleep, school and activities for the child and can be anxiety provoking for parents.

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An average preschool and primary school child has 3-8 coughs or colds per year. Sometimes several coughs or colds occur one after the other. A child who lives with smokers has an increased risk of developing coughs and colds.

A cough is a reflex action to clear your airways of mucus and irritants such as dust or smoke.
Coughs may be dry or chesty and most coughs clear up within three weeks.

Cough may be broadly split in to three categories:

Acute cough = < 3 weeks

Prolonged acute cough = 3-8 weeks, slowly resolving, e.g. post-viral pertussis

Chronic cough   = Variably defined from 3-12+ weeks

Needless to say that constantly hearing your child cough especially at night is bound to cause concern. Even if the mother is happy her child is otherwise well someone else will make a comment. It may be a well meaning grandparent, a dad returning from work or a teacher who will ask whether the child has seen a doctor. I have to say when I see a child  with a cough I examine the child step by step explaining as I go along what symptoms and signs which would cause me as a doctor to be concerned. This not only makes me rule out significant causes of cough but it also reassures and educates the mother as to what important signs she should be looking for.

  • has the child lost their appetite?

  • are they playing or responding as normal?

These symptoms are most important when you are deciding if your child is unwell in that if the child is showing both of the above symptoms you must  keep a closer eye on your child so that if they go on to develop any signs listed below you can visit your GP  On many occasions I have seen a child in surgery racing around, playing happily and having eaten a good breakfast.  Be reassured a child with a cough in this situation is not needing to see a doctor.

However, If you notice any of the following associated with a cough you must bring the child to the doctor

  • has trouble breathing or is working hard to breathe

  • is breathing faster than usual

  • has a blue or dusky colour to the lips, face, or tongue

  • has a high fever (especially if your child is coughing but does NOT have a runny or stuffy nose)

  • has any fever and is younger than 3 months old

  • is an infant (3 months old or younger) who has been coughing for more than a few hours

  • makes a “whooping” sound when breathing in after coughing

  • is coughing up blood

  • has stridor (a noisy or musical sound) when breathing in

  • has wheezing when breathing out (unless your doctor already gave you an asthma action plan)

  • is weak, wingy, or irritable

  • is dehydrated; signs include dizziness, drowsiness, a dry or sticky mouth, sunken eyes, crying with little or no tears, or passing urine less often (or having fewer wet nappies)

Because most coughs are caused by viruses, doctors usually do not give antibiotics for a cough. A cough caused by a virus just needs to run its course. A viral infection can last for as long as 2 weeks. We very rarely send a child for a chest X-ray. 

Unless a cough won’t let your child sleep, cough medicines are not needed. They might help a child stop coughing, but do not treat the cause of the cough. If you do choose to use an over-the-counter (OTC) cough medicine, discuss with the pharmacist to be sure of the correct dose and to make sure it’s safe for your child.

Do not use OTC combination medicines  they have more than one medicine in them, and children can have more side effects than adults and are more likely to get an overdose of the medicine. Some cough medicines have the effect of making a child hyperactive which most parents would agree is not a desired side effect!

Cough medicines are not recommended for children under 6 years old. Meanwhile, you may want to try this homemade remedy my mother gave to us as children and remains a good remedy.

HOMEMADE COUGH MEDICINE 

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Honey, lemon and glycerine (a liquid I use in Christmas cake Royal icing to make the icing softer) is a homemade remedy for coughs provided the person  is not allergic to any of the ingredients. It is not adviseable to give to a child < 12 months. Honey is a natural antibiotic and lemon is full of cold-fighting vitamin C and glycerine is good for soothing sore throats.

It can also be bought ready mixed over the counter.

Store in the refrigerator for up to a year. For sore throats and chest congestion take one teaspoonful every few hours. (If it starts to taste so good you want to pour it over ice cream – you are probably getting better and don’t need it any more.)

¼ cup (60ml) freshly squeezed lemon juice
¼ cup (60ml) liquid honey
¼ cup (60ml) food grade glycerine

Strain the lemon juice through a fine meshed strainer. Whisk together with the honey and glycerine and pour into a glass bottle with a tight-fitting lid.

Store in the refrigerator for up to a year. For sore throats and chest congestion take one teaspoonful every few hours.

Remember to train your child to cover their cough in order to help protect  those who are vulnerable from catching an infection. 

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ARE YOU A CARER OR DO YOU KNOW SOMEONE WHO IS?

Are re you a carer?

If you look after your partner, or a relative or friend who is ill or disabled, you are a carer, even if you don’t think of yourself that way.

There are many ways that you might care for someone.

For instance you might:

  • be on hand 24 hours a day to provide care
  • arrange hospital appointments for someone
  • drop round each day to keep someone company or cook their dinner
  • visit a relative who lives far away once a month to see how they’re doing.
  • Whether you’ve cared for the person for a long time, are temporarily helping them (for example, while they recuperate from an operation), or have just become a carer, take time to review your options and find out what support is available to you.

To establish your rights as a carer refer to  Age UK on the following link

http://www.ageuk.org.uk/home-and-care/advice-for-carers/your-rights-as-a-carer/

The Care Act comes into force in May 2015. It changes the way the social care system will work in the future.

You’ve probably heard about the biggest change: a care cap that means no-one will spend more than £72,000 of their own money on their care needs.

If you need care, or look after someone who does, you’ll need to know how care is changing.

Befriending

Ways it may affect you from April 2015:

  • You will have a right to a free needs assessment from your council, even if it thinks your finances are too high or your needs are too low to qualify for help.
  • All councils will use a new national eligibility criteria to decide whether someone can get help from them.
  • If you get social care support, you will now have a right to request a personal budget if you’re not offered one. This is a summary of how much the council thinks your care should cost. This might be useful if you want to pay for your own care. This will become more important when you have a care account from April 2016 (see below).
  • If your needs assessment shows you don’t qualify for help from the council, they must advise you how the care system works and how to pay for your own care. So if you just need a hand with housework, for example, the council should assist you in finding this.
  • You can defer selling your home to pay your care fees until after your death.
  • If you’re paying for your own care, you can ask the council to arrange your services for you. It can only charge you as much as someone whose care they are funding.
  • If you’re a carer, you have a legal right to a care assessment from the local council. You can also get support services if you qualify for them.
  • If you find it difficult to communicate or to understand the issues being discussed, the council must provide an advocate to help you when discussing your care. They will represent your interests if you don’t have a friend or relative who can help
  • The council must provide preventative services that could reduce or delay your need for care. For example, intermediate care at home after a hospital stay could help keep you independent for longer.

Ways it may affect you from April 2016:

  • It becomes even more important to get a needs assessment, as the council will then set you up with a care account. This tracks the amount of money spent on your eligible care needs. The word ‘eligible’ is important as it only includes the needs covered by your assessment. So if you decide to hire a cleaner but the needs assessment doesn’t say you need this help, the cost of that won’t be included.
  • There will be a cap on how much you have to spend on your care needs. Anything you or the council spend on your eligible needs will be added up in your care account. Once it reaches £72,000, the council will pay for all your eligible needs. This excludes your daily living costs, which include things like your food and accommodation in a care home.
  • The council can reassess your care needs, even if you pay for your own care. This is because the council works out how much your care should cost to meet your eligible needs, and adds this up in your care account. It needs to check every so often that the amount it thinks you should be spending is still right.
  • New rules about top-up fees in care homes mean you may be able to pay them yourself. Top-up fees may apply if you move into a care home that costs more than the council can pay.
  • If you’re not happy about a decision, you have a new right to complain and appeal it, and for this to be independently investigated.

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                         For more information:
Call Age UK Advice: 0800 169 6565

To all carers

You  can obtain local support at the Ealing Carers – details on a previous blog

https://wordpress.com/post/52087738/1596

When you’re caring for someone it’s easy to overlook your own needs. But looking after your health and making time for yourself can help you feel better and manage better with your caring role.

Your health

Tell your GP you’re a carer, and discuss the impact this is having on your own health. They will be able to offer you advice and support, and you may be entitled to additional health services such as a free annual flu jab if the person you care for has a serious or ongoing health problem.
Although it can be difficult, try to make sure that you eat healthily, stay active and get enough sleep.

Don’t feel like you need to do everything yourself. If you have relatives who live nearby, try to be honest with them if you need a hand or want to share the responsibility.

I’m Emotional health

Don’t overlook your emotional health. Family and friends, carers’ groups , your GP or counsellor, or organisations like Samaritans can all provide you with space to talk about how you’re feeling.

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If you care for someone with dementia, it can be hard to share any feelings of guilt, sadness, confusion or anger with them, leaving you feeling isolated. It’s important to acknowledge your feelings, and remember there’s no right or wrong way to feel.

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Your social life

It’s a good idea to take up a hobby or activity, such as going to an exercise group or an evening class, if you can. Taking part in an activity you enjoy will give you the opportunity to do something for yourself – it’s important that you have your own interests and make time to pursue them where you can.

Your local library can provide information about social activities, events, education and courses. The University of the Third Age (U3A) can also tell you about courses in your area.

Please refer to a previous blog

https://102theavenue.wordpress.com/2014/07/11/fight-loneliness-and-improve-your-health/

 
 

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