CLASSROOMS are buzzing with kids’ return to school – but it brings risk of infectious diseases.
Uptake of childhood vaccines is at an all-time low, with one in five starting primary school without having their booster jabs.
It leaves individual children and the wider community vulnerable to serious but easily preventable illnesses such as measles.
The “4-in-1” pre-school booster, given from three years and four months, is a crucial shield against polio, whooping cough, tetanus and diphtheria.
It’s vital for parents to check their child’s vaccine records and catch up on missed innoculations – you can ask your GP surgery if you are not sure.
On a more positive note, the NHS is introducing a chickenpox jab for children aged one to three, starting in January.
Vaccines are a cornerstone of modern medicine, saving thousands of lives in the UK every year.
So please, make sure your child is protected for the sake of their health, and everyone else’s.
Here’s what readers have asked me this week . . .
Q) TWO years ago I began suffering from a completely blocked nose. It worsens when I am cold or the weather is cold, during summer when I have hay fever, and during the night.
I cannot breathe at all through my nose for extended periods of time and have been sleeping with my mouth open for two years.
I have tried steroid sprays from my doctor but they do not help. I now experience fatigue as well as ulcers.
It has also affected my self-confidence, due to people asking why I have a constant cold. I am 36 years old.
A) It is clear from what you have written that this long-standing problem is affecting your physical, mental and even social health, and it is absolutely time to request a referral to an ENT (ear, nose and throat) specialist for further assessment.
There are long waiting lists at the moment, but if you’re willing to travel slightly farther, you can use the My Planned Care website to compare waiting times at different hospitals.
This may include local private hospitals that are offering NHS appointments and treatment to help bring the NHS waiting times down.
In the meantime, while waiting to be seen, it’s worth trying steroid nasal drops, which some people find more effective than sprays.
These tend to be most helpful if the problem is predominantly due to inflammation – allergic rhinitis, commonly known as hay fever; non-allergic rhinitis, or chronic sinusitis – and the drops can take several weeks of consistent use to be fully effective, so stick with it.
Other potential causes include structural problems – such as deviated nasal septum, enlarged turbinates (which are bony structures inside the nose), or nasal polyps (soft-tissue growths that block airflow) – which steroids alone will not fix.
Less common causes include adenoid hypertrophy in adults or, rarely, growths in the nasal passages.
One final piece of advice would be to start a daily nasal-hygiene routine, using either a saline nasal spray (such as Sterimar) or a nasal douching system (for example, NeilMed sinus rinse).
This is good practice for anyone who has nasal symptoms, and arguably for everyone.
Keep it next to your toothbrush and get into the habit of spraying or douching every time you brush your teeth.
This is in addition to using any steroid sprays or drops.
ALTERNATIVE TO HIP REPLACEMENT OP?
Q) In The Sun On Sunday, a 46-year-old woman suffering with osteoarthritis asked for your advice after her GP said that a hip replacement would not be suitable for her.
Although your letter to her was spot-on, I wondered why – owing to her relatively young age – you didn’t maybe mention the excellent alternative of hip resurfacing?
As you are no doubt aware, this is less invasive and ideally suited to a younger candidate.
My brother-in-law had his first operation done 23 years ago, followed by a second op on the other hip 13 years ago.
The results have been marvellous – still to this day.
A) In my first draft response, I had mentioned hip resurfacing.
However, this procedure is not suitable for everyone and there are actually more contraindications for women than there are for men.
For example, people with smaller bones have higher complication risks with this treatment.
Also, women who may become pregnant should not have hip resurfacing, owing to concerns about the release of metal ions (cobalt and chromium) which could have possible effects during any pregnancy.
It was also unclear what level of investigation this woman had and what the exact nature of the under- lying problem was.
I never want to give anyone false hope in this column, or cause confusion by mentioning treatments that may turn out to be unsuitable.
So my judgment on this occasion was to just provide guidance towards the next steps.
In this woman’s case, that was an assessment with the correct specialist team, alongside the correct investigations.
Following which, she can be provided with information about the most appropriate solutions for her.
I HAVE CONCERNS OVER MY ORAL HEALTH
Q) I’M a quite fit 71-year-old woman with oral lichen planus, which developed a few years ago.
I was prescribed betamethasone, but due to difficulty obtaining it, this will soon change to prednisolone.
Is there anything else I can try? I try to maintain my mouth and gums to the best of my ability and visit my dentist and hygienist twice a year.
A) Oral lichen planus is a chronic inflammatory condition that can flare up and remit – and while it isn’t curable, there are ways to get symptoms under control.
The standard first line of treatment, as you have already been prescribed, is topical steroids (such as betamethasone, prednisolone, or clobetasol) to help reduce inflammation and discomfort.
If you feel that this isn’t working very well, it could be helpful to ask your consultant whether you could use a custom dental tray to keep the medication in contact with the affected area for longer.
Another type of treatment is topical calcineurin inhibitors, for example tacrolimus or pimecrolimus ointment. These are sometimes used if steroids are ineffective, but they are generally second-line due to concerns about long-term safety.
Other things you can add to help include topical anaesthetics (lidocaine mouthwashes or gels) for flare-related soreness, and especially before eating.
Use saliva substitutes or sugar-free gum if dryness worsens irritation, avoid triggers such as spicy, acidic or very hot foods, which can worsen symptoms, as can alcohol or smoking.
Stress can also play a role in flare-ups.
Use a mild, SLS-free toothpaste (sodium lauryl sulfate can irritate OLP).
Report any persistent ulceration, thickened patches or changes (rarely, OLP can turn cancerous, so regular dental/oral medicine reviews are important).
On rare occasions, oral immunosuppressants can be used, but these are usually reserved for severe disease and managed by an oral medication specialist.
TIP OF THE WEEK
SOMETIMES smoke alarms are not enough to keep us safe.
If you or a family member are living with a condition that may prevent or delay escape if there is a fire, your local fire department can usually offer free advice, and often a home fire-safety check.
UNDIAGNOSED DIABETES PROMPTS WARNING OF ‘SILENT EPIDEMIC
MILLIONS of people are unwittingly living with diabetes, and are at risk of heart attacks, strokes and going blind.
A study found around 45 per cent of people with the disease worldwide, as many as 248 million, are unaware they have sky-high blood sugar.
In the UK, one in four are missing a diagnosis.
Symptoms are easy to shrug off, like going to the loo more often, particularly in type 2 diabetes.
Published in The Lancet Diabetes and Endocrinology, the analysis also showed only 42 per cent of treated patients hit safe blood sugar levels needed to keep the disease at bay.
It means just 21 per cent of those living with diabetes have their condition under proper control.
First author Lauryn Stafford, of the University of Washington School of Medicine, said: “By 2050, 1.3 billion people are expected to be living with diabetes, and if nearly half do not know they have a serious and potentially deadly health condition, it could easily become a silent epidemic.”
Younger people were more likely to be undiagnosed, but by number, those in midlife made up the biggest pool.
There was also variation across the world; North America had the highest diagnosis rate, at 83 per cent, and West Africa as low as 10 per cent.
Diabetes is when the body does not make enough insulin (type 1) or does not use it properly (type 2).
Sugar then builds up in the blood and, without adequate treatment, quietly damages organs and nerves, with potential complications ranging from foot amputation to kidney disease.
WHAT TO WATCH FOR
FEWER than one in ten people in the UK with diabetes have type 1 diabetes, which is not preventable. The 4Ts are the best way to remember its symptoms:
Toilet: Going for a wee more often, especially at night.
Thirsty: Being constantly thirsty and not being able to quench it.
Tired: Being incredibly tired and having no energy.
Thinner: Losing weight without trying to, or looking thinner than usual.
These can all be signs of type 2 diabetes, too, as well as:
- Genital itching or thrush.
- Cuts and wounds take longer to heal.
- Blurred eyesight.
- Increased hunger.
These symptoms occur because some or all of the glucose from the food you eat stays in the blood, rather than being used properly for energy.
Some people are also more at risk of type 2 diabetes, including people with a higher age, waist size and body weight, as well as family history and ethnicity.
Therefore, unlike type 1 diabetes, there are things you can do to reduce your risk of type 2 diabetes, such as eating healthily, being active and maintaining a healthy weight. These things help manage diabetes, too.
Go to the Diabetes UK website and use the free Know Your Risk tool.