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DR HILARY JONES DR HILARY JONES

Skin cancer is on the increase and has been significantly so for the last 3 decades. Consequently, it is now the commonest form of cancer overall, although thankfully, most types are treatable and not life-threatening. After the hottest weekend so far this year now is a timely reminder on simple ways help to prevent this disease.

The skin is the largest organ in the body and is constantly renewing itself. We shed around 60,000 skin cells every day and replace them all as well. The skin protects us, insulates us, and allows us to control our internal temperature. Yet this constant regeneration and exposure to environmental hazards makes our skin vulnerable. Our skin is especially vulnerable to ultraviolet light from natural sunlight or from sunbeds.

Traditionally, we have been told that UVA radiation causes the changes of ageing and that UVB causes the changes of burning. Both, however, can induce cancerous change and the longer the exposure to the sun over accumulated years, and the higher the number of episodes of burning – especially in childhood – the greater the risk of developing skin cancer.

People with certain skin types – blond hair, pale skin and freckles, are especially at high risk of skin cancer because of their lack of natural pigmentation. Young people can develop skin cancer and many of them die every year, leaving behind young families. Sadly, most are preventable deaths.

Yet everybody is vulnerable given sufficient exposure. Our awful British summers don’t decrease the risk either – in fact more people are holidaying abroad in hotter climates than ever before – and trying to make up for lack of sunshine by frying themselves as soon as they arrive at their destination.

Sunscreen!

Here are a few tips to help prevent sunburn this weekend:

A sunscreen of at least Factor 30 (UVB) with a 5 star rating (UVA) is recommended.
Sunscreen should be reapplied frequently to ensure adequate protection.
The eyes and scalp also need protection with UV filtering sunglasses.
Wear a wide brimmed hat.

This weekend may well be a hot Bank Holiday, so always take safe sunbathing seriously and remember that sunbeds are not a better or safe alternative. Enjoy the sunshine by all means, but just a little at a time!

More helpful information on skin cancer and can be found on the Cancer Research website along with details on other types of this cancer.

This week is National Epilepsy Week so this blog should be very timely.

As a GP, I will see many patients with epilepsy throughout my career.  Given that there are about 500,000 people with epilepsy in the UK, about 1 in 100 will be affected by this condition, most GPs like myself will have about 12 or more patients on their medical list.  It’s important therefore, for GPs to have a good level of knowledge about this not uncommon condition, and that patients themselves know that the GP is in a position to advise and support them.

As GPs we will have people of many different ages living with epilepsy as epilepsy usually starts in childhood, but can affect people of all ages for different reasons.  The GP is also expertly placed to advise patients about self-care and living the kind of lifestyle that will help to control their symptoms manage their condition to an optimal degree and ensure that they can still enjoy an excellent quality of life.  When the diagnosis is first made, it can be daunting for the individual and for their family.  Many myths abound concerning epilepsy but with a good degree of knowledge, good control of symptoms can usually be achieved.

What is Epilepsy?

Epilepsy is a condition that affects the brain and its electrical activity.  When electrical signals are disrupted, it can have far-reaching effects on the rest of the body, resulting in repeated seizures.  It occurs in many different forms ranging from a trance-like state lasting just a few seconds right through to loss of consciousness following convulsions lasting for many minutes.  Sometimes just a small area of the brain is involved, in which case the seizures may be partial, or larger areas of the brain can be affected in which case the seizures may be generalised.

Causes

Often, there may be some degree of brain damage responsible for the epilepsy, and the damage may be obvious, such as following a serious head injury, following meningitis or encephalitis or a brain tumour.  In other instances there may be only minimal damage which is not visible on tests but there is an association with other conditions such as learning difficulties.  In many cases however, no cause is identifiable in which case the epilepsy is known as idiopathic.

Diagnosis

It’s important to understand that anybody can have one seizure during the course of their lifetime for a variety of reasons but this does not constitute epilepsy.  Epilepsy is where seizures are repeated and require treatment.  The diagnosis is often suggestive from the description of the first few seizures.  An electro-encaphalogram and a scan may sometimes throw further light on the underlying problem and confirm the condition clearly.  It’s important to reach an accurate diagnosis as many different conditions can produce similar symptoms to epilepsy, although the treatment needs to be tailored to the individual and a precise underlying diagnosis.

Treatment

Treatment is vital in order to control seizures.  The medicines used are called anti-epileptic drugs or AEDs and in 70% of cases, these are successful in managing the epilepsy and allowing the individual to lead an otherwise normal healthy life.  Often, the type of medication and the dosage may need to be adjusted to achieve optimal results.

Living with Epilepsy

The vast majority of people with epilepsy lead normal, satisfying fulfilling lives to the full.  An important aspect of self-care is leading a healthy lifestyle which involves plenty of regular exercise, a healthy well-balanced diet, and the avoidance of excess alcohol or exposure to other recreational substances.  Considerations may need to be given to activities such as driving, taking the contraceptive pill and pregnancy, but your GP, your hospital specialist and epilepsy support groups can play a fantastic role in advising and supporting people with epilepsy.

Furthermore, new technological developments such as Telecare24’s new epilepsy service together with the special Epi-Care epilepsy sensor which it offers can provide peace of mind and extra support.

Knowing what the triggers are and how to avoid them is key and sometimes keeping a diary to this effect is a good idea.  It’s important to take the medication prescribed exactly as directed for best effect, and a regular review by the GP or the specialist is vital.  There is no reason why people diagnosed with epilepsy and treated to the optimum and under regular review with help from friends and family should not be able to live entirely normal and happy lives.

Epilepsy Charities

There are many charities that offer fantastic support to people of all ages who have epilepsy. Here are a few helpful links.

Epilepsy Action – This is the working name of the British Epilepsy Association. The website has lots of advice and information on the condition. They also have a network of local groups where you can find support and get involved with raising awareness. They also have a helpline on 0808 800 5050 or email them on helpline@epilepsy.org.uk.

Young Epilepsy – Established in 1897, Young Epilepsy aims to provide advice, support and help for young people so they reach their full potential. They also offer specialist education at their St piers School and college for young people with neurological conditions. Young Epilepsy also offers Rehabilitation Services. You can contact them on 01342 832243 or via helpline@youngepilepsy.org.uk.

Epilepsy Society – This is the working name for The National Society for Epilepsy. The Epilepsy Society are a powerful voice in the community and are involved in medical research as well as providing a range of medical and care services for people with Epilepsy. You can speak to them on 01494 601400.

This week is Dementia Awareness Week with many charities such as the Alzheimer’s Society raising awareness of this debilitating condition. We hear a lot about the importance of mental agility and keeping our brains active in good working order as an antidote to the onset of dementia. But it seems physical activity is just as vital also.

Currently, some 800,000 people in the UK suffer from dementia, with 17,000 younger people included among them. In the next decade there will be over a million people living with this dreaded condition and two thirds of them will be women. Yet only 43% will ever get a diagnosis and only 700,000 carers will be involved in looking after them.

Currently, there is no cure for the majority of these dementias, and medication has so far proved disappointing once the condition has begun. Research into the underlying cause is painfully slow. That is why it is such good news that recent research has shown that sustained and regular exercise boosting stamina and endurance can halt the progress in most people of cognitive decline.

Excercise Can Help Prevent DementiaOver thousands of years, humans have evolved to become capable of sustained endurance activities. This increased aerobic capacity has benefits for metabolism and physiological function of the brain. A protein known as brain derived neurotropic factor (BDNF) is known to be important in the development, survival and plasticity of nerve cells called neurons, and important in protecting against neuro degeneration associated with Alzheimer’s disease and other forms of dementia.

Regular aerobic exercise boost the level of BDNF by 2-3 times and clearly the more often exercise is undertaken the more prolonged the effect. The decision making, dealing with stress and fear in our everyday life, our brains need to adapt and since exercise has been shown to enable us to do this, it may well explain how it can be effective in preventing depression, anxiety and other mental disorders.

It is frightening to know that around the world 7.7million new cases of dementia are diagnosed every year. With an ageing population that figure is growing all the time. So why not get exercising today and every day could well save you from one of the fates we all fear most.

If you are concerned about developing Dementia or are anxious about a friend or relative then there are plenty of organisations to turn to.

You may find a careline alarm useful in providing some peace of mind. It’s not always possible to be there 24/7 for a relative, but a careline alarm enables people to simply push a button worn around their neck. You can also include sensors such as Door Exit sensors if they are prone to wandering. If activated the alarm opens up a conversation with a trained care operator. The operators are trained to deal with dementia sufferers and provide immediate assistance is required. Contact your Local Authority or contact a company such as TeleCare24 who provide this service across the UK.

You can also get support from Charities such as:

Alzheimer’s Society
The Alzheimer’s Society has a national helpline on 0300 222 11 22 where their trained advisors can offer information, support and guidance. They also run Dementia Cafes locally where both carers and people with dementia get to meet others in similar circumstances and take part in engaging activities.

DementiaUK
DementiaUK  aim to improve the quality of life for everyone affected by dementia. They provide a network of Admiral Nurses who specialise in dementia care as well as psychological support for family carers. You can contact them on 020 7697 4160 or via info@dementiauk.org. You can also call the Admiral Nursing Direct Helpline on 0845 257 9406.

Dementia Friends
Dementia Friends is an initiative run by the Alzheimer’s Society that aims to create one million dementia friends who can help people with this condition to live better lives.

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