Tag Archives: Asthma

Have you seen the Dragons in the surgery garden?

Don’t worry I haven’t lost the plot – read on

Many people have talked about fairies at the bottom of the garden but I want to tell you about the dragons at the bottom of the surgery garden. You may be surprised at my letting out this long guarded secret but I felt it was time to let the secret out! They are very friendly and the young dragons often play with fox cubs and cats from next door. I have to say they only come out when all the patients and infact all the staff have gone home. I hadn’t told anyone and poor Dr Livingston got such a shock when they appeared one night when she was busy working after surgery had finished. I think she thought she was back in Wales as there are so many there but they are red and talk Welsh. The dragons in the garden are green and you can easily miss them.
I first came across red dragons in Wales : they are so important that the flag of Wales (Cymru) is a red dragon!!! ( Y Ddraig Goch) and has been for many years ( 1,184 years to be precise) ever since the red dragon conquered the white dragon .


The story as written by Nennius a monk tells how young boy visited and revealed to King Vortigern, last of the Celtic kings of Britain that he had seen two serpents, one white and one red, who had been hidden deep underground fighting with fierce shrieking until finally the red one summoned his strength and drove the white one away.
The story is then explained by the mysterious child: “the two serpents are two dragons; the red serpent is your dragon, but the white serpent is the dragon of the people who occupy several provinces and districts of Britain, even almost from sea to sea: at length, however, our people shall rise and drive away the Saxon race from beyond the sea, whence they originally came.” The King then left North Wales where this event took place and built a castle in the South (on the Welsh/English border ) it was thought to be Caerwent, in Monmouthshire now part of Gwent.

It’s interesting that in February 2003 during his enthronement at Canterbury Cathedral Archbishop Rowan Williams ( a welshman from Monmouth wore hand-woven gold silk robes bearing a gold and silver clasp that showed the white dragon of England and the red dragon of Wales to symbolise the peace between the two countries.

The red dragons are very friendly now but do tend to breathe more fire if England is playing rugby against Wales!!


Story strictly for children ( adults can only read under child guidance)

Here’s a picture of the family in the garden. If you can’t see them because of their green colour ask a 3/4 year old because they always manage to find them and some children have seen blue and purple ones aswell!
The family of dragons that live in the garden are Denis(means friendly) who is 5 years of age, his mother Daphne(because she was born under the laurel tree) and father Derek ( meaning ruler) and Dolcie ( means sweet one)who is just 6 months. I don’t know how they ended up living in the surgery garden but they do have a slightly Irish accent and they are green so perhaps Liz or Mary the nurse had something to do with it!
Also Derek’s brother is called Declan…..makes you wonder!

The Day Denis Dragon couldn’t breathe fire.

One evening last week when the sun was shining I was busily working and I suddenly heard a tap at the window. At first I thought it was the cat at the door miaowing for milk but when I  looked up I saw Denis Dragon looking very sad. I thought he had probably kicked his ball over the wall whilst playing with the cat and he wanted me to get it. I opened the doors to the garden and said , “What’s the matter Denis ?”
“Dr . Bayer I can’t br….br…. breathe fire.
It was poor Denis, he was wheezing (not the cat miaowing) and he was very breathless and no fire was coming from his mouth. That is very serious for a dragon because breathing fire is very important to heat their food and keep themselves warm and keep dangerous creatures away.
The next thing his mother Daphne was scampering up the garden and looking very worried.
“Come inside both of you and don’t worry Denis I have a special steam machine which will make you better in no time and don’t be frightened because its a bit noisy. It sounds like Thomas the Tank Engine warming up before he trundles off to see Edward and Henry along the track.” I said

We walked slowly to the back room and I listened to Denis’s chest , counted his pulse on his wrist and how fast he was breathing and put a funny machine on his finger- it pinched a bit and the lights came on and numbers started appearing and I told Denis that I was measuring his Oxygen. It wasn’t long before I had set up the steam machine (adults call it a nebuliser)by squeezing some special medicine out of a tiny plastic bottle into a into a little cup and connecting by a tube to the machine. “Are you sitting comfortably,Denis?” I said and Denis shuffled a bit and held his mummy’s claw. I put the mask over his nose and mouth (a special one as dragons have big noses) and I switched the machine on. His mummy stayed with him all the time and as the steam puffed out Denis slowly felt much better and after we stopped the machine after about 5 minutes Denis was so happy to be feeling better that he gave a huge puff of fire so much that my tea nearly boiled out of the mug!

Here is a picture of a little boy on a nebuliser


” Now Denis that’s not the end of story, because your mummy has told me that for a little while she has noticed that you have been getting more and more tired, the fire you have been blowing has been getting less and less and at night you have been coughing all the time . It has been worse since the trees and flowers have been in flower showering out pollen. Also she noticed that when you were racing with the cat and fox cubs that you were nearly always last and were not wanting to play with them anymore. I think you have got something called asthma.
Human being children come to the surgery with this all the time and when we give them special medicine which they have to breathe in they get better and can play happily with their friends and start running as fast as their friends again and for young dragons they can breathe fire more easily.
The breathing medicines are called inhalers, because breathing in is called inhaling and the one I will give you is a blue one: it is called Ventolin and is called a reliever because it makes you better.
You must be very senlsible and never play games squirting it in the air and you don’t have to try it out first just shake it and you will hear the liquid in it swishing about.
It is very important that you use these inhalers whenever your chest feels tight and you need to give one to your teacher in case you start wheezing in school and remember to take it with you when you go out anywhere.

This only relieves you for a short while and at this time of the year your chest will easily get tight so I think it is a good idea to take something to prevent or stop you getting wheezy.
Guess what we can give you another inhaler to do this and what do you think it’s a called? ”
Denis thought for a while , “is it a stopper?” said Denis.
Not quite I said. Try again, I said it prevents wheezing that’s a clue.
“I know it’s a preventer” shouted out Denis nearly singeing my hair with the fire he breathed out in excitement.
You must take this in the morning before school and when you get home in the evening.
There is just one thing I must show you with before I teach you to use the inhaler. When children including dragon children try to breathe in with the inhaler it is so hard a bit like when you were a baby and it was hard to drink out of a cup so we have special thing called an aerochamber and this makes it much easier. When you use the aerochamber your breathing will be much better and mummy will be very happy to see you much better and will give an extra special bear hug.
Infact here are the instructions shown by a friendly bear. I think dragon children like teddy bears to cuddle aswell!
Click on link……


Posted by on July 18, 2013 in Training and Advice


Tags: , , , , , ,

LEAFY EALING -the hot spot for allergy

Ealing is known as the leafiest borough in London and whilst many of us enjoy the treelined streets others are suffering the miserable conditions of hay fever and asthma.
London plane is a beautiful tree with its characteristic bark on the trunks and maple-like leaves.

The London plane is very tolerant of atmospheric pollution and root compaction, and for this reason it is a commonly planted tree in cities such as London.
The tree is fairly wind-resistant. However, it has a number of problems in urban use, most notably the short, stiff hairs shed by the young leaves and the dispersing seeds; these are an irritant if breathed in, and can exacerbate breathing difficulties for people with asthma and hay fever. The large leaves can create a disposal problem in cities. These leaves are tough and sometimes can take more than one year to break down if they remain whole.

At the moment the trees especially the limes aswell as grass are showering their pollen and causing havoc in Ealing but for sufferers the rain may come to give some respite. The combination of pollen and diesel makes the reaction much worse.
For those who want prior warning click the link below
The pollen count is a measurement of the amount of pollen in the air. The higher the count the more severe symptoms of hay fever can become (depending on the specific type of pollen you are allergic to).
The Met Office provides a pollen forecast. If the count is high you can take preventative steps such as taking an antihistamine before leaving the house.
Hay fever symptoms can start as early as April with pollen from some trees like Birch,Lime and Plane.  May, June and July are the times when various varieties of grass pollinate, and some even stretch into August. Weeds and fungi spore anytime from April through to November. It also seems that these times are extending now as we feel the effects of global warming and the changing weather patterns.
Who is affected?
Hay fever is one of the most common allergic conditions. It is estimated that there are more than 10 million people with hay fever in England.
Hay fever usually begins in childhood or during the teenage years, but you can get it at any age.
The condition is more common in boys than in girls. In adults, men and women are equally affected.
Hay fever is more likely if there is a family history of allergies, particularly asthma or eczema.
Classical allergic salute – horizontal creasing of the nose secondary to persistent itching and rubbing: this is a sure sign of allergy in the nose
Symptoms of hay fever
Sudden sneezing
Your nose will probably be very watery, runny and you feel congested
Irritation and itchy eyes, soon turning watery
Onset off uncontrollable sneezing
You may well feel itchy in the mouth, nose and throat areas
A loss of smell and food may taste different
Your face may well feel swollen too
Self help tips
It is sometimes possible to prevent the symptoms of hay fever by taking some basic precautions, such as:

    • wearing wraparound sunglasses to stop pollen getting in your eyes when you are outdoors
    • change your clothes and take a shower after being outdoors to remove the pollen on your body
    • try to stay indoors when the pollen count is high (over 50).
    • Avoid cutting grass, playing or walking in grassy areas, and camping.
    • Try to stay indoors when the pollen count is high (over 50).
    • Keep windows and doors shut in the house. If it gets too warm, draw the curtains to keep out the sun and keep the temperature down.
    • Don’t keep fresh flowers in the house.


  • Vacuum regularly, ideally using a machine with a HEPA (high-efficiency particle arresting) filter.
  • Damp dust regularly. Dusting with a wet cloth, rather than a dry one, will collect the dust and stop any pollen from being spread around.
  • Keep pets out of the house during the hay fever season. If your pet does come indoors, wash them regularly to remove any pollen from their fur.
  • Don’t smoke or let other people smoke in your house. Smoking and breathing in other people’s smoke will irritate the lining of your nose, eyes, throat and airways, and can make your symptoms worse.
  • Keep car windows closed. You can buy a pollen filter for the air vents in your car. This will need to be changed every time the car is serviced.
  • Rub a small amount of Vaseline inside your lower nostrils. This can help prevent pollen from entering your nasal passages.
  • If possible, avoid drying clothes outside. This will help prevent bringing pollen into your house.

Listen to the expert talk about Hay Fever

More information
Posted by Dr Bayer



Tags: , , , ,


What’s the problem?
This week we were visited by the prescribing advisor whose main purpose was to advise us about how we can prescribe more economically and reduce waste with the aim of reducing our drugs bill.


I remember when I was a trainee GP ( now known as GP registrars) and worked in a large practise in Bridgend. It was a large detached house in the middle of the town and at the front door there was a large holly bush. A decision was made to cut the bush down to whitewash the exterior of the house and low and behold, behind the bush it was jam packed with prescriptions where patients had taken them from the doctor and then pushed them behind the bush on leaving the surgery! Doctors on a regular basis were prescribing to humour the patient and patients were taking them to humour the doctor!

I found a picture without holly bush!!

Aswell as being made aware that a lot of medication  never got  dispensed I also discovered
that when I visited patients homes I was frequently shown carrier bags of unused medication often out of date by years!!  Now if a patients medical condition doesn’t  improve one of the first questions is “have you taken the medication as I suggested?”
Not only does it mean that that their symptoms can get much worse if left untreated – the latest Department of Health report suggests this can cost the NHS many, many millions in avoidable extra treatment costs – it also means that these medicines cannot be used again and need to be incinerated.
The potential money wasted on medicines across Greater London, could pay for;
• 13,484 hip replacements
• 16,892 knee replacements
• 1,963 community nurses
• 3,300 drug treatment courses for breast cancer
• 50,000 more drug treatment courses for Alzheimer’s
A report by the Department of Health estimates that unused medicines cost the NHS around
£300 million every year, with an estimated £110 million worth of medicine returned to pharmacies, £90 million worth of unused prescriptions being stored in homes and £50 million worth of medicines disposed of by Care Homes.
It is also of interest that the biggest financial and carbon savings came from reducing drugs wastage.
Why do patients not take their medication?
The reasons why patients don’t take all their medication can vary and audits have shown that around half of all the medication returned had not even been opened. This means that patients are ordering and receiving medication that they don’t even start to use.
Other reasons include:-
* patients not believing the medicine is necessary;
* possible side effects;
* fitting taking or using medicines into daily routines;
 * choosing between medicines if patients’ feel they are taking too many
* cutting down or stopping medicines they have been taking for a long time..

How Can You Help?


There are a number of ways that you can help to reduce the issue of wasted medicines and save money for your local NHS.
        • Please let your GP or Pharmacist know if you’ve stopped taking any of your medicines
        • Check what medicines you still have at home before re-ordering. Discuss your medication with your GP or Pharmacist on a regular basis


      • Think carefully before ticking all the boxes on your repeat prescription forms and only tick those you really need
      • If you don’t need the medicine please don’t order it! If you need the medicine in the future you can still request it.
      • If you need to go into hospital, please remember to take all your medicines with you in a clearly marked bag.
      • Please also remember that your medicines are prescribed only for you; it’s not safe to share them with anyone else.
      • Even if you never open them, once medicines have left the Pharmacy, they cannot be recycled or used by anyone else.
      • Please bring your unused medicines to the Pharmacy for safe disposal.



      • NEVER dispose of your unused or unwanted medicines down the toilet
      • Unused medicines are a safety risk
      • If your medicines change – return your old medicines to the pharmacy for safe disposal to avoid mixing them up with your new medicines
      • Don’t stockpile medication – it is a safety risk for children and others who might take them
      • Store medicines in an appropriate place out of reach of children

Addressing asthmatics – please don’t use your volumatic as a mini cold frame in the garden (as one asthmatic confessed to doing after being challenged about his excessive demands for repeat prescriptions)-  this is the proper use




  • On a final note……
    When you use your asthma inhaler there is no need to squirt a dose into the air before using it!!

    posted by Dr Bayer

Tags: , , , ,