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Do you need a skin lesion looked at or removed?
Do you need a skin lesion looked at or removed?
Troy Martin - Saturday, May 27, 2017

We have doctors available all day on Wednesdays at Blackbutt Doctors Surgery specifically for this job.  

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We're Hiring!
We're Hiring!
Troy Martin - Tuesday, May 23, 2017

  

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Men's Health in May!
Troy Martin - Monday, May 08, 2017

 

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Heart Failure Help Advice
Heart Failure Help Advice
Kevin Parker - Tuesday, August 09, 2016

I find many patients look very glum when I tell them they have “heart failure” and I can understand why -it sounds terrible doesn't it? However it is not as bad as it sounds.

“Heart failure” means that the heart is not pumping as well as it once was. The heart is weakened, and will need some special care.

Your GP and cardiologist can work out a personalised program, for what your heart really needs – and does not need – to work well. However here are some basic things that most people with heart failure will need to be aware of.

Fluid intake – most will do well with around 1.5L daily. Too much fluid, and the heart will have trouble pumping it around the body, leading to swollen ankles, high blood pressure, breathlessness and coughing. Too little and kidneys will be too dry. Ask your doctor what they would suggest you drink in a day. Keep a fluid diary for a day or two of everything you drink, to help them out.

One easy way to monitor you daily fluid intake is to fill a jug with water in the morning you have a cuppa, fill the kettle from the jug, if you have a cup of juice, tip an equal size cup out of the jug...and then you will be able to pace your fluid intake over the day.

Weigh yourself each morning. Try to weigh yourself at the same time every day, without any clothes – for instance when you get up in the morning.

We can all gain or lose weight over time, but any sudden increase or decrease in weight could indicate you are keeping fluid and may need to talk to your doctor or nurse.

Alcohol – sorry to say despite what you read about red wine being good for the heart, the best amount of alcohol if you have heart failure is none. Alcohol has extra fluid you do not need, and the alcohol itself is poisonous to heart muscle fibers. People with heart failure should not drink any alcohol.

Reduce salt intake.

Salt makes you thirsty and makes you retain fluid. If you need help working out how much food you can eat, how much salt you are eating now, a dietician can be a big help. They can help you make sense of food labels, and find hidden sources of salt.

You can reduce salt by taking the salt shaker off the table, not adding salt during cooking, and eating food you prepare at home. If you prepare fresh foods at home you will know how much salt is in it....packet foods and takeaway often have way too much salt. It is amazing how fast your taste buds can adjust to no added salt – you will soon be able to enjoy the natural salt and flavour in foods.

Keep your weight under control - the more there is of you, the more your heart has to work hard to pump the blood around. Most of us carry too much weight – ask your doctor what your ideal weight would be, and for some help making a plan to get to it.

Watch blood pressure – if the blood pressure is high, the heart has to pump hard against it, and will wear out sooner. Ask your doctor what blood pressure you should aim for, but most people will need to keep in the 120/100-140/80 range. Blood pressure can be kept low by – you guessed it – keeping a watch on slat and fluid, watching weight, and taking medications as directed.

Medications – your doctor may recommend some medications for your heart failure. It is important to take them as directed, and quickly tell your doctor if you have any problems with them. These medications will strengthen the heart and make it last longer. Missing medication can be a cause of the heart being overloaded.

How will I know if my heart failure is getting worse? What are the dangerous sings? The symptoms below are not good – if you have theses symptoms or are getting worse, you need to see your doctor.

  • Suddenly putting on weight, 1 or more kilos in only 24-48 hours
  • Becoming much more breathless, even if you do small things
  • Waking up in the night gasping for breath
  • Having to sit up in bed or sit out of bed to breath at night
  • Getting very swollen ankles and legs
  • Feeling nauseated
  • Feeling very fatigued

I find many people with heart failure are frustrated early in the course of their illness that they need to come to the doctor often, and often have their medications changed each visit. Medicine can do a great deal, but it is not as good as the body and all the natural adjustments it makes each day without us even knowing. When you are first diagnosed, or if your heart failure has been playing up, you may to see the doctor every few days, change medications several times in a week , and keep a close track on your weight and fluids.

You can help your heart to get on stable track by keeping a diary of weight, fluid intake and symptoms, taking your medications as directed and keeping in close contact with your doctor. It wont' always be so labor intensive!

How can I get all this organised?

See your GP and get a care plan and Team Care arrangement. This document will make sure you get all your instructions for the next year, and that your doctor, nurse, cardiologist and pharmacist are all on the same day. This should have your specific fluid, blood pressure weight and exercise targets. You should also carry a copy of your current medications – even thought this may need to be often updated!

Educate yourself and your family about heart care, the following resources are very helpful for you and your family to optimise your heart:

  1. Living Well With Heart Failure
  2. Heart Failure Beyond The Basics
 

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Stick to That No Smoking Resolution!
Stick to That No Smoking Resolution!
Kevin Parker - Tuesday, August 09, 2016

Was it your new year’s resolution to cease smoking?

What a great health change to stop smoking this year. This is the single best gift you can give your body to be smoke free.

We all know stopping smoking is difficult – but help is at hand! Different things work for different people at different times......the trick is to keep trying until you find the best way to get smoking out of your life, and your family’s life.

What sorts of options are out there, what will it cost, and will it really work? These are questions my patients often ask and the answers are listed here. Your pharmacist or doctor can help you even further to find out what path to a smoke-free life will work best for you.

Nicotine Replacement Therapy (NRT)

Nicotine is the addictive part of the cigarette smoke, and it is safer to satisfy your nicotine craving with one of these products, than to take in the poisons in cigarette smoke. Over time, you can gradually reduce the amount of nicotine by reducing the strength and how often you use the nicotine replacement. Getti ng the right dose is really important, otherwise you will feel ill, or still be craving a cigarette. Your pharmacist or GP will ask you some questions, and recommend options depending on your individual situation. Some products can be subsidised by the government on script. Gum, patches, lozenges, inhalers……..so many ways to beat the cigarette!

Tablets to reduce the nicotine cravings – if you really find you are dependent on nicotine, it is known that use tablets to help you quit smoking makes it more than twice as likely that you will really quit. There are two types of tablets available, Champix (Varenicline)and Zyban(bupropion). The government provides a government subsidy for one course of these medications per year. They help reduce the cravings for a cigarette. To see if this is right for you, see your GP. As a GP, I have seen people quit smoking who have been smoking for 60 years using these medications, so they do work!

Fake cigarettes (ENDS – electronic nicotine delivery systems), Hypnotherapy, Acupuncture – we all know people who have quit using these! They aren’t too harmful, and can really help the quit smoking effort.

All of these are cheaper than continuing to smoke…… So ask your GP or pharmacist today and join the thousands of Australians giving smoking the flick in 2013!

Okay so now we have talked about the medical ways to help giving up smoking...

What about ways to strengthen that good ol’ will power! (Or won’t power!)

Here are some useful tips to give up anything....

  • Recognise that urges come in waves......if you are CRAVING a cigarette or a chocolate or whatever is your poison....it may seem impossible that you will be able to resist for the rest of the day! But usually people find if they can just hang in there and resist for 10mins, the craving passes. So just take it a minute at time when the urge hits.
  • Think about your values and think positive! “ I take care of my body” “ I am really getting healthier and healthier in 2013” “ I am going to be so much fitter by the time city to surf comes around” “ I really believe my kids need me to be healthy:”- hard to hold on to that thought and do something that damages your health at the same time.
  • Get organised in advance. So you know that your hand is going to be itching for that wine glass at 5:30pm, or that when stress hits you, you will find the pantry irresistible....so plan ahead. We are all creatures of habit – and this can work for us as well as against you. Beat the after work drink by going straight out for a walk or to the gym and nowhere near the pub of fridge. Plan ahead your stress strategy – make a list and put it by the phone or in your hand bag so it will prompt your mind when you need it. Here are some suggestions from my patients......call a friend, play a game on my phone, suck ice, go in the shower and sit under the water for 10 minutes, listen to music, file my nails....anything to distract! But it needs to me near to hand, and not involve a big, big box of chocolates.
  • Recognise a slip is not a failure – turn it around fast! Most humans change gradually- not every can do a 180 degree turn with style! If you find yourself half way through the cigarette….. or the packet of cigarettes....don’t spiral into guilt. All too often we think like this – “ O h dear, I knew I could not give up smoking, I’ve done it now, I am so weak, I might as well smoke the rest..” No! Not true! Finish your chocolate, cigarette, glass of wine, and calmly get rid of the rest of the temptations...and get back on that horse! The person who occasionally slips up is going to still get many more health benefits than the person who goes back to their bad habits full time at the first sign of trouble. Be kind to yourself, and give it another go.
  • The best way to break a bad habit is make a new one.......think about the good things you would like to bring in to your life, not just the bad ones to remove. And make is something you can really enjoy. To stop smoking and start watching box set of favourite TV show.....good idea! Stop smoking start walking the dog with a friend at the end of the day……..even better idea!
  • This leads in to the idea of rewards. I take my hat off to those who stop smoking and use the money they have saved to go for a holiday at the end of the year......no way I can hold out that long for a reward! I find most people are the same – they need daily and weekly good things to happen as a result of their choice – otherwise it gets hard to stick to. When we first give up smoking, sugar, alcohol or caffeine, we may feel pretty crummy...that detoxification process can be no fun. Keep going by knowing the facts about the big difference you small change is going to make (for smoking, go tohttp://www.icanquit.com.au/media/4528/040141_benefitsofquittingfs.pdf, for all those encouraging facts, like that at 1 years your risk of a heart attack is ½ that of a smoker) and reward yourself with something in the here and now! Get that manicure, plan that weekend away, go to the movies and buy yourself that new X-Box game you have been wanting – just do it soon, and make sure you keep the motivation high.

Good luck with those new years and better health resolution, and remember if you need some help, your GP has helped many people just like you turn their health around, so come on in and get some professional help if you could use it.

 

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QUIT SMOKING -PREPARATION IS THE KEY!
QUIT SMOKING -PREPARATION IS THE KEY!
Kevin Parker - Tuesday, August 09, 2016

SET A QUIT DATE 

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Don't Panic About the Pap!
Don't Panic About the Pap!
Kevin Parker - Monday, July 11, 2016

Worried about an abnormal Pap smear result? You are not alone! But I have good news – 90% of abnormal Pap smear results ARE NOT CANCER!

Every week I see women, who have done the right thing and taken their regular pap test – and are now terrified to receive an abnormal result.

I put this down to the fantastic level of public awareness we have in Australia about preventing cervical cancer – and this is a good thing, as we have one of the lowest rates of cervical cancer in the world.

Over 3 million women will have a pap smear this year – and only about 800 women will be diagnosed with cancer, and most of those will not have had regular pap smears.

So if my abnormal pap smear is probably not cancer, what is it?

–a bit of blood or mucous on the slide

– an inflamed cervix

–an infection (not necessarily an STD)

–HPV and CIN changes

HPV and CIN are the things pap smears are looking for – these things can lead to cervical cancer if left alone. But you have a long time between being detected as having HPV or CIN and cancer (often 10 years or more), and there is very effective treatment available. Many women will not even need treatment -the body can often heal itself, they just need more regular check-ups.

Just because you have an abnormal pap smear, it DOES NOT necessarily mean

–you will have problems having babies

– you have an STD

–you have cancer

–you will need surgery

Many of the changes we detect can heal themselves. If the gynaecologist needs to take a closer look, you may be sent for a colposcopy. At Blackbutt Doctors Surgery, we have Dr Seshu Mandapati performing Colposcopies each week.

So Don’t Panic about the Abnormal Pap result – talk to your GP. It is probably not cancer.

To read more, please click on the following link: http://www.cancerscreening.gov.au/internet/screening/publishing.nsf/Content/cv-pap-smear-l

 

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Dealing with Depression and Anxiety
Dealing with Depression and Anxiety
Kevin Parker - Monday, July 11, 2016

Coming to the doctor to talk about depression or anxiety?

Talking to your GP about a change in your mental health is a very good place to start to get you on the road to recovery. GP’s care for many people who are feeling low or distressed. They can help you find a way back to a better frame of mind.

If you are coming to see the doctor about feeling sad, overly worried, irritated, or generally tired and stressed, there are some things you can do to get the most out of the consultation.

1. Keep a diary leading up to the consultation. Some things doctors are interested in include:

  • what time you went to bed
  • what time you got up in the morning
  • use of alcohol or other drugs
  • mood, how did you feel each day
  • any particularly bad times, and what happened at that time
  • any particularly good times, and events around that

Some excellent mood diaries include:

2. Take a standardised questionnaire about mood. There are some questionnaires that help your doctor know where you are at – try the K10 here.

If you are pregnant or have a new baby, it may be useful instead to try the Edinburgh postnatal depression score, here.

Each of these can be printed out, filled in and reviewed with your doctor at your consultation.

3. Book a longer appointment. It will take time for you and your doctor to talk about your problems, and come up with the best treatment plan. A 30 minute appointment is suitable for this. We have many of these available, so please ask when making the appointment for a long appointment.

4. Come with an open mind. Many things help improve mood, but they all involve change from one’s current lifestyle, habits and thoughts. It can be challenging to be kinder to yourself, change your habits, walk more, drink less and go to talk to a mental health professional or take medication. However in the end, it will make life much better for the person suffering from depression or anxiety, and their family, so be prepared to consider all the options to find what is best for you.

There are Medicare rebates for psychological services available if it is decided that this will be beneficial.

 

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Dealing with the Flu
Dealing with the Flu
Kevin Parker - Monday, July 11, 2016

INFLUENZA IS CAUSED BY A VIRUS. MOST PEOPLE RECOVER AFTER A FEW DAYS, BUT IN SOME IT CAN BE LIFE-THREATENING. TO AVOID INFLUENZA, HAVE AN ANNUAL INFLUENZA VACCINATION. IF YOU HAVE INFLUENZA, COVER YOUR COUGHS AND SNEEZES, WASH YOUR HANDS BEFORE TOUCHING OTHERS, AND STAY AT HOME. 

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