I
hope you all had a chance for some down time over the summer. Now
it’s back to the grind again. School starts up, as does the chilly
air, the longer nights, too many meetings and, of course, the usual
array of fall germs.
When
patients come in with their respiratory germs, don’t forget to
remind the smokers that it’s not too late to butt out.
The
Lung Association’s
Smokers’
Helpline has trained counselors to help
smokers break the habit. The NLMA has worked with the Lung
Association and developed a fax back form we can use to refer
patients for smoking cessation counseling. With the patient’s
permission, we can send their name and phone number to the Smokers’
Helpline counselors who will follow up with the patient and begin a
quit program. This is working very well, but we do have to remember
to send the names in. And — don’t forget — kids start smoking often
before even age 12.
TIPS AND HINTS
Looking
in the throat and doing a throat swab can be a challenge. It
sometimes helps to get the patient to hold his breath — it’s much
harder to gag when holding one’s breath and can help make the swab
a less trying experience. (Dr. Tom Costello)
Some
studies indicate that zinc lozenges, started within 24 hours after
the onset of a sore throat, can lessen the severity of a viral
infection. When patients come in having woken that morning with a
sore throat it’s a good recommendation and may satisfy their desire
to take an antibiotic.
We
are all used to epidemics of germs — there seems to be one causing
obesity and it is gaining hold. I find that encouraging people to do
even a three-minute walk a day and build from there is helpful.
People often are puzzled as to why they are gaining weight. I find
it helpful to explain that our metabolism naturally decreases as we
age and if we make no changes in our diet or activity level, as we
approach middle age we will gain two to three pounds per year.
Speaking
of weight loss, the Atkins fad is still upon us although the press
lately has given some time to its downsides. I tell patients that
the best weight loss diet is probably the diabetic diet — it watches
carbs and fat. I inform them that whole wheat products are less
fattening than white and that can encourage them to eat more whole
grains.
HUMOR HELPS
Ever
have patients come in three days after they have run out of their
hypertension pills? I’m sure your patients are not much different
than mine. I’d like to get angry, but I haven’t found much success
that way. I have found a humorous approach useful. I say, in a
light-hearted tone: “Don’t tell me, the pill fairy got you didn’t
she?” When they look puzzled, I explain how there’s a pill fairy
that gets into medication bottles and makes the bottle look full so
that the person doesn’t notice it getting emptier every day, until
one day you open up the bottle and there’s not one left! They
usually get the message that one can see one’s supply shrinking and
that it’s then they need to call. It’s a way I’ve found to get my
opinion across without damaging our relationship and I find it
usually works!
There’s
lot’s of experience among the docs in this province. Found something
works for you? Fax or e-mail your hint and we’ll spread it around
(like a pleasant germ).
Have
a good fall.
Dr.
Susan King is a family physician in St. John’s. Tips and hints may
be emailed to nlma@nlma.nf.ca or faxed to 709-726-7525. |
