Do not eat or drink anything for several hours after vomiting.
Sip small amounts of water or suck ice chips every 15 minutes for 3-4 hours.
Next, sip clear liquids every 15 minutes for 3-4 hours. Examples include water, sports drinks, flat soda, clear broth, gelatin, flavored ice, popsicles or apple juice. Do not drink citrus juices or milk. Increase fluids as tolerated.
When you can tolerate clear liquids or diluted apple juice for several hours without vomiting and if you’re hungry, try eating small amounts of bland foods. Try foods such as bananas, rice, applesauce, dry toast, soda crackers (these foods are called BRAT diet). For 24-48 hours after the last episode of vomiting, avoid foods that can irritate or may be difficult to digest such alcohol, caffeine, fats/oils, spicy food, milk or cheese.
When you can tolerate bland food, you can resume your normal diet.
Retake medications if vomiting occurs within 30
minutes of taking usual medication. If you vomited after taking oral
contraceptive pills, use a back-up contraception method for the rest of
If diarrhea is the only symptom, try Imodium, a non-prescription (over-the-counter) medication available at any pharmacy according to package directions. Follow a bland diet (see 4 above). After the passage of a soft, formed stool, you can resume a normal diet. Call for medical advice if you have no improvement within 48 hours after starting Imodium.
Topical treatment includes wart paints containing salicylic acid or similar compounds, which work by removing the dead surface skin cells. I recommend Salactol Paint. The paint is applied once daily. Treatment with wart paint usually makes the wart smaller and less uncomfortable; 70% of warts resolve within twelve weeks of daily applications. • Soften the wart by soaking in a bath or bowl of hot soapy water. • Rub the wart surface with a piece of pumice stone or emery board. • Apply wart paint or gel accurately, allowing it to dry. • Cover with plaster or duct tape. If the wart paint makes the skin sore, stop treatment until the discomfort has settled, then recommence as above. Take care to keep the chemical off normal skin.
How about other methods?
Other methods have scientifically not proven more successful and are often not available on the NHS
Find below a list of Mental Health Resources that you may find useful for your own Mental Health journey. You may also wish to register on this website (see registration section on the right hand side) for occasional non-promotional local NHS information emails by Dr Kittel and Forest Health PPG.
Low back pain and Sciatica are incredibly common conditions in highly developed, civilised societies. According to some reports, more indiginous societies (i.e. tribes in the Amazon etc.) rarely suffer back pain. This is probably due to better core strength in less civilised peoples.
What should I do with acute back pain in a nutshell: 5-point plan:
Take painkillers that you are not allergic to i.e Ibuprofen (beware indigestion) and / or Co-codamol (beware constipation) over the counter and take them regularly for a few days. Always read the drug information sheet in the pack.
Read the NHS write up on back pain, it contains lots of good information.
Buy Robin McKenzie “Treat your own back” (see below)
Ask your doctor to refer you for physio if your backpain hasnt improved after 2 weeks or see your practice physiotherapist.
Contact your doctor, should you have any “red flag symptoms” described in the NHS leaflet.
More on Low back pain and Sciatica
These 2 conditions are the most common ones causing patients pain and disability. There is a really good overview on the NHS website . However, there are a few additional resources that I would like to share.
The Book: Robin McKenzie, “Treat Your Own Back” for a quick fix.
This is a 30 year old book based on a 60 year old method that my own doctor recommended to me and truly, with a few stretches, a lot of people are able to improve their back pain quite significantly. Thus, I believe it is the best £10 I ever spent on my own back.
The StartBack Tool is a good tool to assess the chance of Chronification in Low Back Pain. Click here to download and complete it. The scoring method is explained on the second page. If you score highly, seek help early, as you are much more likely to suffer this condition for a long time.
The Back Pain Booklet
Almost 20 years old, this booklet is still very relevant and helpful. Click here to download this file. It is double sided A5 and a bit tricky to print, but the content is very good
Why an MRI scan is commonly a useless investigation
An MRI scan is a tool to get a good 3D photograph of our spine. It is very sensitive to abnormalities like disc bulges, slippage etc. However, many people with disc bulges lead completely normal lives without any symptoms. Equally, people with entirely normal MRI scans suffer severe back pain. Click here for MRI scan results of the spine for normal people without back pain.
Should I see my GP with Low Back Pain?
Most GPs are not well placed to treat Low Back Pain. Apart from painkillers, with a various degree of side effects and health hazards attached to them, they often can do little to help back pain. However, many practices now employ senior physiotherapists (First Contact Physiotherapists), who can be helpful in the assessment and treatment co-ordination of Back Pain.
Of course there are exceptions where Low Back Pain has more serious causes and there is a good summary on the NHS website quoted above. If you think your symptoms may be more serious, you should see a health professional quickly.
Phone number changes for cancelling ‘Extended Hours Clinics’ appointments- Bracknell and Ascot
A telephone number for residents to call when cancelling evening or weekend GP appointments, as part of Bracknell and Ascot’s ‘Extended Hours Clinics’ service, has changed.
The new number is 01344 233 300 and is available Monday to Friday 8.30am -6.30pm and during clinic opening times, Monday – Sunday inclusive of Bank Holidays. Please note that the old number – 01344 637 808 – is no longer in use.
The change coincides with Berkshire Primary Care Ltd, who is commissioned by East Berkshire Clinical Commissioning Group (CCG) to provide the service, moving offices.
The clinics continue to run from Boundary House Surgery as usual.
The ‘Extended Hours Clinics’ are available for people who find it difficult to take time off work or have other commitments during daytime hours. The service offers a range of appointments with GPs, nurses, healthcare assistants and phlebotomists (blood tests).
People must be registered with a GP surgery locally to access the ‘Extended Hours Clinics’ and appointments can only be made in advance through their own GP practice, as the service cannot accept walk-in patients.
Appointments are for routine general practice issues only and not for urgent care. If urgent care is required, please call NHS 111 for advice.
Although residents need to book appointments through their individual GP practices, they are urged to call the cancellations line if they are no longer able to make the appointment.
The ‘Extended Hours Clinics’ in Bracknell and Ascot are part of a national initiative to improve access to general practice.
Please find below the Prevention and Self Care report for the Frimley ICS 2018. While mainly aimed at Health Professionals I believe you may find the information inside interesting, particularly page 6 of 17. The Bracknell Programme may be good for yourself or a friend or family member? Click here if you cannot see the document below.
Be very careful with painkillers (i.e. Ibuprofen is a real enemy of good kidney health)
Research your kidney friendly diet, CKD etc online, start here
Kidneys and CKD (Chronic Kidney Disease)
Kidneys are amazing organs. They detoxify our bodies on a daily basis and get rid of most things the liver and bowels cannot get rid off. And many people have healthy kidneys until their old ages. However, an increasing number or people in the UK have Chronic Kidney Disease. (CKD), similar to blood pressure is actually a condition rather than a disease as most people dont really suffer with it. Many people do not have any symptoms or only have minor symptoms until the condition is relatively advanced.
Doctors in the UK tend to warn patients when their eGFR (Glomerular Filtration Rate = the rate at which your kidneys work) drops below 60, which is an arbitrary, yet probably sensible line according to todays knowledge. NICE classifies most people with a
Usually, patients need 2 readings of an eGFR (the rate at which your kidney works) below 60, 3 months apart, to be diagnosed with CKD stage 3. A single reading is not enough. Stage 3 means that you have now moderate disease (stage 2 is mild and stage 1 is normal and these stages are medically only important for people with pre-existing kidney damage).
Prevention of CKD3
However, I would encourage everybody with CKD 2 to already take measures to avoid their kidney function to drop. Aging drops kidney function anyway, but it is the acceleration of this drop we need to avoid. Simply go to the top of this page for the key messages.
I have got CKD 2 or 3 – What next?
Dont panic – most people with CKD 3 will NEVER end up on dialysis or need a kidney transplant
Get informed – the internet is your oyster. There is so much written about a kidney friendly lifestyle.
Prepare – Change your diet, get fitter, try to be positive and happy if you can, drink plenty of water, implement the key changes listed above.
Be critical – Protein clogs kidneys up, yet a lot of recipes even on really good websites contain too much protein and too little vegetables. Also, remember, replacing animal protein such as meat and dairy products with plant proteins such as beans, lentils and tofu is better for your kidneys. Learn about kidneys. Make up your own mind. And do what you think is right.
Start the day with a mix of fibre and seed containing foods with plenty of fluids can relieve constipation in 80-90% of patients.
All these incredients can be obtained at health food stores i.e. Holland & Barretts and mixed according to taste in a big cereal container.
Eating a bowl of this cereal every day will after a few days relieve most peoples constipation.
Patients suffering irritable bowel syndrome are advised to avoid dairy and eat the cereal using a variety of fruit juices.
Should you still suffer symptoms after starting your dietary changes, please see your doctor again.
For very young children that cannot yet have the above cereal I usually recommend to give Porridge with some Linseed and a mashed up banana for breakfast (mash and mix banana into hot porridge to cool down and add linseed). You can also put linseed into yoghurts etc.
Take it seriously. Cholsterol clogs up your blood vessels. It is a major cause of heart attacks, strokes and cancers including bowel cancer. And remember, having your Cholesterol tested every year and doing nothing about it is like weighing yourself every week. Absolutely no point.
Adjust your diet: What is bad?
Lard, dripping and goose fat
Fatty meat and meat products such as sausages
Full fat cheese, milk, cream and yogurt
Coconut and palm oils and coconut cream
Adjust your diet. What is good?
Porridge, Oatbran, Oat breakfast cereals, Oatcakes, Bread made with 50% oat flour or oat bran
Pearl barley, Adzuki beans, black beans, black-eyed peas, butter beans, cannellini beans, chickpeas, edamame beans, kidney beans, lima beans, mung beans, navy beans, pinto beans, split peas, white beans
Red lentils, green lentils
Vegetables rich in soluble fibre such as okra, aubergine, citrus fruits, turnip, sweet potato and mango
Unsalted soya nuts (also called roasted edamame beans)
Soya alternative to milk, yoghurt, Soya mince/chunks, Tofu
Start exercising. Cardiovascular = sweat producing exercise. Three times a week for 45 minutes or 5 times a week for 30 minutes.
Try to loose weight. Slimming reduces cholesterol.
Cook from fresh. Don’t buy ready made products.
Stop smoking and drink sensibly. Help is available for both.