St Bernards Well

Green Practice

Stockbridge Health Centre

1 India Pl, Edinburgh, EH3 6EH

Appointments 260 9226
Enquiries 260 9227

Practice Closed - Monday 18th September 2017 - Public Holiday. Please contact NHS24 - 111 if Urgent.

Clinics & Services


Asthma Chronic Obstructive Pulmonary Disease Heart Disease Well Person Check Wart Treatment
Ear Syringing Mental Health Services Diabetes Clinic Contraception Human Papilloma Virus Vaccine
Carers Joint Injections      

Asthma

Asthma is an inflammatory condition that affects the lungs causing narrowing of the airways and resulting in the symptoms of breathlessness, cough, wheeze and chest tightness. The symptoms can be kept under control with inhaled medications.

  • 5.1 million people in the UK have asthma, and there are approx 2000 deaths but asthma deaths are largely preventable
  • 1 in every 8 children has asthma and 1 in 5 people with asthma also have hayfever
  • Allergic conditions such as asthma, hayfever, eczema and food allergies often go hand in hand and some patients have all of these together
  • Asthma is thought to run in families as do other allergic conditions and is associated with maternal smokers (children are born with smaller airways)
  • There is no know cure for asthma but children can grow out of it although it may return in later life

What happens at an Asthma Review?

  • Discussion of symptoms
  • Peak Flow measurement if aged over 5 years
  • Inhaler technique reviewed
  • New inhalers instigated if required
  • Discussion regarding triggers and their avoidance
  • Smoking cessation if required
  • Personal self management plan provided including how to manage an asthma attack
  • Offer flu vaccine for the winter

Patients with asthma should be seen at least once a year for a review with the Practice Nurse and will be prompted to attend with a note on their repeat prescription slip.

Further information available from:
www.asthma.org.uk Tel:- 08457 010 103


Chronic Obstructive Pulmonary Disease (COPD)

COPD is an umbrella term which includes Chronic Bronchitis, Emphysema and Chronic Asthma. In COPD the airways in the lungs are damaged through constant irritation and the most common reason for this is smoking.

The overall prevalence of COPD in the UK is approx 1% (1.5 million) with more men affected than women:

2% of men aged 45-65 years
7% of men aged over 75 years

30,000 people die each year in the UK from COPD compared to 2000 asthmatics.

COPD accounts for 5.4% of all deaths in men and 3.2% in women.

The disease is characterised by breathlessness, productive cough, wheeze and chest tightness. Diagnosis is by lung function testing normally performed at the hospital and although there is no cure the symptoms can be managed using inhalers to deliver medication to the lungs to improve their function. Some patients may require nebulisers or oxygen if the breathlessness is severe.

The most important measure is to stop smoking as this will help slow down or even halt the progression of the disease. It is also vital to exercise within your limitations, eat a healthy diet, get a yearly flu vaccine and a one off pneumonia vaccine and learn to recognise when your condition is worsening so that chest infections can be treated promptly to avoid hospital admission.

What happens at the COPD Nurse Led Review

  • Discussion regarding symptoms
  • Pulmonary function testing
  • Inhaler technique review
  • Change or addition of inhalers if necessary
  • Referrals to physiotherapy (pulmonary rehabilitation) if required
  • Issue of personal self management plan with antibiotics for use at home for worsening symptoms
  • Breathing techniques shown
  • Discussion regarding attendance allowance, blue badges and taxi cards if required and any need for help at home

Patients with COPD are invited twice a year to see the Practice Nurse for a review - this tends to be spring and autumn to tie in with the administration of a flu vaccine prior to winter.

Further advice available from: www.chss.org.uk Tel 08450 776 000


Coronary Heart Disease Nurse Led Clinic

Cardiovascular disease i.e. coronary heart disease and stroke is the main cause of death in the UK accounting for 4 out of every 10 deaths.

Heart disease is the leading cause of death in women killing nearly 4 times more women each year than breast cancer. Women are not aware that heart disease is the number one risk factor to their lives while 1 in 6 men will die from heart disease.

There are many factors that can put you at greater risk of having a heart attack or developing heart disease such as angina and we know that controlling risk factors has been proven to reduce the risks of heart attacks and strokes. For example stopping smoking, eating a healthy low fat diet, keeping your weight at a normal level, taking regular exercise and drinking alcohol within recommended limits can all help reduce the risk of heart disease.

It is just as important to make lifestyle improvements if you have already had a heart attack or have existing heart disease as this can reduce the risk of further attacks. To this end the practice runs a heart disease clinic to which all of our patients with confirmed heart disease are invited once a year for a review with the Practice Nurse.

What happens at the clinic?

  • You will be informed of your blood results (which are taken a few weeks before your clinic appointment) - cholesterol level, kidney function, blood glucose level and liver function tests
  • Blood pressure will be taken
  • Height, weight and BMI recorded
  • Discussion regarding your diet regime, exercise and alcohol intake and how you can make improvements if needed
  • Smoking cessation advice if appropriate
  • Discussion about any symptoms you may have been experiencing such as chest pain or tightness or breathlessness which may be a sign of worsening heart disease
  • Your current medications will be discussed with time to ask questions about their function, potential side effects etc
  • Opportunity to ask questions about heart disease and any other concerns you may have
  • Leaflet advice is provided as required

Further advice about heart disease can be found at:

www.bhf.org.uk Tel 0131 226 3705
www.chss.org.uk Tel 08450 776 000


Well Person Checks

The Practice Nurses offer health checks to both women and men. Included in this 20 minute appointment:

  • Blood Pressure
  • Height, weight and BMI
  • Diet, exercise and alcohol intake advice
  • Breast awareness discussion
  • Testicular self examination discussion
  • Smoking cessation advice
  • Risk assessment for coronary heart disease, diabetes and hypertension - blood tests may be taken if appropriate
  • Prostate cancer risk discussion
  • Family medical history discussion
  • Time to discuss your own health concerns
  • Leaflet advice provided

Please contact appointments on 260 9226 to arrange a well person check.


Wart Treatment (Verrucca)

What are warts?

Warts are simply areas of skin which grow faster than normal and become toughened in appearance due to the presence of the wart virus. They are most common on the hands, feet and face but they can grow almost anywhere in the body. They are infectious and some people, especially children, are more susceptible than others. A verrucca is simply a wart growing on the weight-bearing surface of the foot which grows inwards rather than outwards because it is pressed on when you walk. As warts are caused by a virus infection the body will build up resistance over a period of time and eventually the body will cause the warts to disappear. This may take months or sometimes years but is the natural way the body deals with warts. If you allow them to disappear in this way it is less likely that you will get any further ones as you will then be immune to that virus.

How can you get rid of warts?

These are two simple methods for getting rid of warts either by freezing with liquid nitrogen or using a wart paint or gel as described below. The second method takes a little time and effort but is usually effective within 2 to 12 weeks.

What you need?

  1. A bottle of wart paint. 'Duofilml' or 'Diswart' are as good as any and are available without prescription from chemists.
  2. A roll of surgical tape ('Micropore' or 'Blenderm' are good), either 1 cm or 5 cm wide depending on the size of wart(s) to be treated.
  3. A pummice stone or emery board for use only on warts (Remember, warts are infections)
  4. Patience. It takes up to 12 weeks to get rid of warts and perseverance is the key.

What to do:

Every night:

After washing the affected area:

  • Apply the wart paint to the warts, getting as little as possible onto the surrounding skin
  • Put a piece of tape over the wart big enough to stop the paint getting rubbed off on the bedclothes overnight

Every other night:

Before applying the paint, rub away at the white, dead warty skin with the pummice stone.

Points to remember

  1. You will need to keep going until you get down just below the level of the surrounding skin to eradicate a wart completely. Stop when the base of the wart looks exactly like normal skin (ie no black dots or 'graininess). If they become sore or bleed a little just leave off the treatment and carry on the following night.
  2. You do not need to take special precautions if you go swimming or walk barefoot to avoid infecting other people. The risk to other people is very little.
  3. If verrucca's are painful to walk on try covering them with a corn plaster - the type with a hole in the middle - to make them more comfortable until you have chance to get rid of them.


Ear wax & Ear syringing

The earhole is a 3 cm tunnel which ends at the eardrum. The wall of this tunnel is covered with normal skin and hairs, and has small glands that produce wax. The wax waterproofs and protects the skin. A self cleaning action usually clears the wax away.

Sometimes too much wax is produced or the old wax is not cleared away by the body. The wax may block the tunnel and make you feel deaf or uncomfortable. The usual way to get rid of the wax is either to syringe the ear (flush out the wax with a fast stream of water), sucking out the wax with a special suction device, or carefully extracting it with a special instrument.

If your ear is usually healthy, we will syringe the wax, but like to soften the ear wax first.

If the doctor or nurse finds wax in your ear we suggest you:

  1. Use warm almond or olive oil (available from your pharmacist)
  2. Lie on your side, insert 5-6 drops into the ear
  3. Stay on your side for 10 minutes, Try to avoid inserting cotton wool as this soaks up the oil
  4. Repeat on the other ear, if necessary
  5. Insert oil twice a day for 7 days
  6. Make an appointment with our Practice Nurse to have your ear syringed (if necessary).

If you continue to get build ups of wax in your ears then you may find that using the ear drops regularly helps the wax drain out.

Do not put things in your ear (like cotton wool buds or bits of tissue). These can damage the ear.

Patient Leaflet


Mental Health Services

As well as having our local Community Psychiatric Nurses and psychologists visiting the health centre to see our patients, we also offer annual longer appointments for patients with long-term mental health problems. As with all appointments here, this service is entirely confidential

In these appointments, you could talk with your usual doctor about recent problems and try to anticipate any future problems. This is often helpful as people can make it clear what they know might trigger a difficulty and what they would prefer us to do - or not to do! We also offer some basic checks on your physical health - for example weight, blood pressure, or advice on smoking. If appropriate, a review of your medications could be discussed


Diabetic Clinic

Diabetic clinics are held by Dr Reid or Dr Lamb

Diabetes occurs because the body can't use glucose properly, either owing to a lack of the hormone insulin, or because the insulin available doesn't work effectively.

More than 2 million people in the UK have the condition, and up to 750,000 more are thought to have it without realising they do.

More than three-quarters of people with diabetes have type 2 diabetes mellitus. This used to be known as non-insulin dependent diabetes mellitus (NIDDM) or maturity-onset diabetes mellitus. The remainder have type 1 diabetes mellitus, which used to be known as insulin-dependent diabetes mellitus.

Diabetes is becoming more common probably related to increasing levels of obesity but there is a lot that can be done to reduce the severity of any complications from it.

Why do I need to come to the clinic ?

The aim of diabetic care is to minimise the number and severity of complications of diabetes by advising you about controlling your diabetes effectively.

Regular diabetic checks can help to prevent the complications of the disease

What are the complications of diabetes?

Poorly controlled diabetes leads to long term damage to the very small blood vessels in the body. This results in damage to the eyes, kidneys, to the heart and the major arteries and to the nerves in the hands and the feet, and sometimes to the gut.

What happens at the diabetic clinic?

Fiona Sanders,our head receptionist, coordinates the clinics and will contact you when your appointment is due to arrange an appointment for you to see Linda McMillan the Health Care Assistant. She will take some blood tests a week or so before the clinic, to monitor your kidney function and your diabetes. You will also need to bring a urine sample passed first thing in the morning. She will measure your blood pressure and weight and test the urine for glucose and protein.

At the Clinic

You will usually be seen by one of the practice nurses first and she will discuss any questions you have. She will also check your feet and circulation. You will then see one of the doctors to discuss any changes to your treatment that may be needed. He or she will also discuss any problems that concern you. Please make an appointment with your usual doctor if you have problems to discuss that are not to do with diabetes.

How often do I need a check?

If your blood sugar is well controlled then once a year is fine, if you have high blood pressure under good control then every 6 months is enough. If your blood pressure is not well controlled then the doctor may suggest seeing you every month and if your sugar levels are variable. every three months.

What other checks do I need?

Once a year you should have your eyes examined by a specially trained optician to look for early signs of damage. If this is caught early it can often be treated by laser. Lothian has a scheme where you will be automatically called for this. You should also have your feet checked at least once a year by the podiatrist.

What blood tests will I have?

Haemoglobin A1c (HbA1c): This shows how well controlled your blood glucose has been over the previous 3 months. Good control is s 7.0% or less.

eGFR: ( estimated glomerular filtration rate). Is a guide to how well your kidneys are working. If you have reduced kidney function then you will have additional checks on calcium and phosphate. every 6 months.

Cholesterol: You may be asked to fast for this blood test. Lipids are made up of:

"bad" cholesterol - "LDL"

"good" cholesterol - "HDL"

"triglycerides" - The doctor will use these levels to advise you whether you should be on a statin to reduce this level and your risk of heart disease. As a guideline a cholesterol level below 5mmol/L, with an LDL below 3mmol/l, and triglycerides below 2mmol/l is good.

Liver Function tests: these are checked periodically if you are on Metformin or one of the glitazones for blood sugar control, of if you are on a 'statin' tablet for high cholesterol, to make sure you can continue to take these tablets.

A 'first-thing-in-the-morning' urine sample. You will be asked to bring along a specimen of the first urine you pass in the morning and will be tested both at the surgery and at the lab for protein.

Microalbumin (protein): increased levels of microalbumin suggest a higher risk of developing complications of diabetes and needs early treatment. These can both be helped with 'ACE-inhibitor' tablets.

Lifestyle Issues

Use the diabetic clinic appointment to discuss

  • Your general well-being, including how you cope with your diabetes and your mood.
  • Your current treatment
  • Your diabetes control. Recent research has suggested that most patients with type 2 diabetes do not need to monitor their blood sugar levels at home - indeed it may even be detrimental - so we no longer advise this.
  • Any problems you may be having. These can be to do with anything to do with your diabetes including work, pain, problems with vision and sexual difficulties. Men commonly develop problems getting or maintaining an erection; do talk to the doctor about this as treatment maybe very successful. Other things to discuss include smoking, alcohol consumption, stress and physical exercise. Please raise any or all of these issues with your diabetes care team.

These sites offer additional help


Contraception

There are many different methods of contraception available and we aim at the practice to provide contraception services to everyone who requires it from new users to people who have just had children and all other women up to the menopause.
We hope the information provided on the site will allow you to have insight into the methods which are available and what we can offer.
Contraception needs to be used until the menopause. That is, until a woman has not had a period or any bleeding for 2 years if aged under 50 and for one year if over 50.
Contraception is free. However over 16 years can buy the emergency contraceptive pill at most pharmacies.

Contraception can be divided into:

Non user failure - these do not depend on you remembering to take contraception

User failure - must be used according to instructions and depend on you remembering.

Long acting methods of contraception

Contraceptive Implant

The implant is a small flexible rod placed just under your skin in the upper arm. It releases the hormone progestogen similar to the one found in the minipill. It is very effective, long term contraceptive which protects you from pregnancy for up to three years. They are over 99% effective. The advantage of the implant is you don't need to remember to take a pill.
The implant unlike the depot injection does not affect your fertility and this will return to normal as soon as the implant is removed.
Periods will most likely change. In some women they stop all together and in others periods will be irregular but generally bleeding will be lighter. Sometimes they are heavier and last longer. There is no method of predicting how the implant will affect you but generally if you know what to expect patients are happy using this method.
It is best fitted during the first 5 days of you period and at the surgery the GP can insert it in a normal 10min surgery appointment. It can also be easily removed and this only needs a double appointment.

IUD/IUS (coil)

Another long acting method, very popular, currently available at the surgery. Referrals can be made and discussed with your GP. The mirena coil is very useful in women with heavy periods.

The Combined Pill

This is just usually called the pill. It contains 2 hormones oestrogen and progestogen the same hormones as produced by your ovaries. There are many different pills. Generally you take the pill for 3 weeks and then have a week pill free when you have a withdrawal bleed like a period.
This effectiveness depends on your age, how often you have sex and whether you follow the instructions.
There are certain people who will not be able to take the pill and this can be discussed with your GP at the appointment.
The pill does have some rare complications but it also has some benefits including protecting you against ovarian cancer.
The combined pill is not recommended in breast feeding women.
It does not protect against sexually transmitted diseases.

The Progestogen Only Pill ( POP)

This pill contains only 1 hormone progestogen similar to the natural one produced by ovaries.
It is also known as the mini pill.
Like the combined pill there are many types available.
The minipill generally needs to be taken at the same time every day and unlike the combined pill there is no break. It does not have any serious side effects but you may not have regular periods.
It does not protect against sexually transmitted diseases.
Can be used in breast feeding women.

Emergency Contraception (The morning after pill)

If you have unprotected sex that is sex without protection or think your contraception may have failed you can use emergency contraception.
You must see your GP, Practice Nurse or pharmacist ASAP

  1. Hormonal contraception known as morning after pill can be taken up to 72hours after sex. It is more effective the earlier it is taken after sex.
  2. The IUD (coil) can be fitted up to 5 days afterwards and can stay in to provide contraception. This method is not currently available at the practice.

Human Papilloma Virus (HPV) Vaccine

The Practice is currently offering HPV vaccine to teenage girls born on or after 1st Sept 1990 and aged 18 or under who may have missed the vaccination campaign at school.

The HPV vaccine is designed to protect against the two types of HPV that can cause 70% of the cases of cervical cancer. Cervical cancer kills 1000 women every year. It is therefore important that teenage girls get protection early enough to be effective.

HPV is spread by intimate skin to skin contact during sexual activity and although you may not be at risk at the moment, HPV is very common and easily spreads. The vaccine doesn't protect against all types of HPV so cervical screening is still required from aged 20 years onwards.

Three injections are given over a period of six months to get the best protection. The side effects are quite mild - mostly soreness in the arm that soon wears off. Serious side effects are rare.

For further information and advice: www.fightcervicalcancer.org.uk

Please make an appointment (0131 260 9226) for one of our Practice Nurses.

Carers

The Practice recognises the important and valuable contribution made by carers and we actively strive to identify and support carers and those being cared for, whether both are registered with the Practice or not. If you are a carer please advise our reception team.

Figures suggest there are over 650,000 carers in Scotland. Carers are more than twice as likely to suffer from poor health compared to people without caring responsibilities.

A carer is defined as:

A person irrespective of age who, without payment, provides help and support on a regular basis to a child, relative, partner, friend or neighbour who could not otherwise manage because of illness, disability, frailty, mental distress or impairment.

The term ‘carer’ would not apply if the person is:

  • a paid carer
  • a volunteer from a voluntary agency
  • anyone providing personal assistance for payment either in cash or kind

We offer a carer review with the Practice Nurse on a yearly basis to every carer registered with the practice and we advertise this review in our newsletter, on our website and on the plasma screen in our waiting room.

At the carer review the Practice Nurse will assess the patient’s own physical and mental health and determine if assistance is required to perform the carer’s role. Referrals can be made regarding help with bathing, medication prompts, equipment required in the home, occupational health or physiotherapy reviews, power of attorney and help can be given regarding finances, disability badges, taxi cards etc. Referrals can also be made to carer support groups such as VOCAL and the Eric Liddell Centre.

More information can be found on these websites:

www.vocal.org.uk - voice of carers across Lothian

www.carers.rog/professionals - The Princess Royal Trust for Carers.

www.alzscot.org – alzheimers Scotland. 0808 808 3000

www.edinburghparkinsons.org – Parkinson’s disease support in Edinburgh

www.eric-liddell.org - project for carers that provides a drop-in social & health based courses.

www.sharedcarescotland.org.uk – short break service. Phone 01383 622 462

All registered carers are entitled to a free seasonal flu vaccination, please contact reception on 0131 260 9226 to find out when our flu vaccine clinics are.

Data Protection and Confidentiality

The principles of confidentiality and data protection do not diminish if the patient is a carer or is being cared for. Written permission needs to be obtained before any identifiable details can be entered into a register and/or medical records:

  • The Practice must obtain consent from both parties (where reasonable and practicable) before any medical conditions, treatments, prognosis, results and needs for support and/or assistance can be discussed. If permission is not granted then information can only be released at the GPs discretion.

Joint Injections

Drs Lamb and Gilson are all trained in steroid joint injections which can be useful for the treatment of inflamed, swollen or painful joints. If you are interested in this procedure we would be more than happy to discuss it further. Please let the reception desk know and they can offer you an appropriate appointment (0131 260 9226).


Practice Information

Opening Hours
Change of Address
Home Visit
Non-English Speaker
Temporary Residents
Direct Access NHS Services
Test Results
Travel
Private Medicals & Reports
Sick Notes
Practice Leaflet
Complaints & Suggestions
Disability Access
Child Wellbeing
Useful Links
News
 
NHS24 111
Data Protection | Freedom of Information | Patients Rights | Privacy Statement
© Green Practice - Stockbridge Health Centre 2006-2017