Hervey Bay Local Health News

All babies cry some of the time. It is their way of communicating they are hungry, they want to be held, or are uncomfortable. It can be difficult and tiring coping with a baby who cries a lot.

It helps to know that if it is colic, it will usually stop by about three months and there will be no long-term effects. It also helps to know that if your baby has colic you are not alone - it has been suggested that up to one quarter of all babies have colic at some time. There is help available for both the parent and the baby.

Signs and symptoms
A baby with colic cries for hours, usually in the late afternoon or evening.

The baby pulls its legs up, clenches its fists, screams and turns red as if in pain.

None of the usual methods (picking up baby, feeding, changing nappy) seem to comfort the child.

What causes colic?
No one really knows for sure what causes infant colic. Possible causes may include:
*    Pain due to spasms of the intestine or due to wind.
*    The baby’s intestines have not yet fully matured.
*    The baby is anxious.
*    The baby senses the parent’s worry.
*    Allergy or intolerance to certain foods (taken by baby or mother).

There may also be a link between parents’ smoking and colic. Lactose intolerance or cow’s milk allergy are often blamed for crying in babies, but these are rare and unlikely to be a cause.

Important
See your doctor if your baby also has:
*    Blood in their bowel motions
*     Blood or a green tinge in their vomit
*     Loss of appetite
*     Woken up over and over in the night, screaming with pain not related to feeding
*     Vomiting and/or diarrhoea that is getting worse or has lasted for more than 24 hours
*     Constipation
*     Changed from being alert when awake, to being sluggish
*     Severe, long lasting swelling of the belly
*     A high temperature (38°C or more)

Common causes of crying
*    Wet nappy or nappy rash
*    Hunger               
*    Too hot or too cold
*    Need to suck       
*    Wind
*    Colic                    
*    Overtired
*    Need to be cuddled
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Asthma can be well controlled by using asthma medicines and avoiding trigger factors (see Asthma Fact Card). The main types of asthma medicines are relievers, preventers and symptom controllers.

Asthma medicines are mostly inhaled directly into the lungs with inhalers, on their own or via a spacer. They can also be inhaled using a nebuliser or taken as tablets, capsules or syrups. The main types of asthma medicines are: relievers, preventers, symptom controllers and combination medications.

Relievers
(e.g. Airomir, Asmol, Epaq, Bricanyl, Ventolin) Relievers relax the muscles in the airways, opening the airways up. This helps patients to breathe more easily when they are short of breath. Asthma may not be adequately controlled if a patient needs to use a reliever most days (in this case the patient should see a doctor).

Relievers:
*    Will help when asthma symptoms get worse
*    Do not treat the inflammation (see Asthma Fact Card)
*    May be used before exercise if exercise triggers asthma.
*    Can cause a rapid heartbeat and shakiness - this is a common side effect for some people. Talk to a doctor, pharmacist or asthma educator if this happens.

Ipratropium (e.g. Atrovent, Ipratrin) is also called a reliever medicine. Ipratropium takes longer than the other relievers to work and therefore cannot be used to relieve symptoms quickly.

Theophylline (e.g. Nuelin) is another reliever medicine, usually taken as a tablet. Theophylline is not used to relieve asthma symptoms as it takes longer than other relievers to work.

Preventers
These medicines prevent asthma symptoms. They reduce inflammation in the airways and make them less sensitive to trigger factors.

Preventers are usually inhaled (e.g. Flixotide, Intal, Pulmicort, Tilade, Qvar).

There is a new preventer medicine (e.g. Singulair, Accolate) which is a tablet. This may be taken instead of, or with, an inhaled preventer and is suitable for some patients with asthma.

Preventers:
*    Need to be used every day, even when symptoms are absent.
*    Will not stop an attack once it has started.
*    Take time to work, when first started. The patient may not notice an improvement in the asthma for two weeks or more.
*    Should not be stopped, unless a doctor advises.
Prednisone, or prednisolone, tablets (or syrup) are preventers mainly used to treat severe asthma symptoms. They are usually only taken until symptoms improve and can be controlled by regular asthma medicines.
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Hervey Bay doesn’t claim the title of Whale Watching Capital of Australia for nothing and now the first whales of the season have been spotted up at the north end of the bay. That means that the whale watching season will soon be in full swing and there will be lots of people heading outdoors to see these wonderful creatures.

If you’re one of those who are going out on one of the many whale watching cruises that will run through this season then you need to be prepared and Beachside Pharmacy can help to equip you with all the gear you’ll need. We stock a wide range of:

• sea-sickness remedies
• hats
• sunscreens
• sunglasses and
• disposable cameras

You can even print your digital whale watching photographs right hear in the pharmacy or burn them to a CD.

The Beachside Pharmacy is open 7 days a week so come in and let us set you up for an enjoyable day out on the water.

Asthma is a common condition that affects approximately two million Australians. It is estimated that up to one in four children, one in seven adolescents and one in 10 adults will experience symptoms of asthma at some time.

What is asthma?
In people with asthma, the airways in the lungs are twitchy or sensitive. When exposed to certain trigger factors (something that makes a person’s asthma worse), the airways tighten, the lining of the airways becomes red and swollen and mucus is formed, causing the air passage to become narrower.

What are the main symptoms?
Asthma symptoms may vary from person to person. Possible symptoms include:
*    Coughing
*    Wheezing - a high pitched whistling or sighing sound on breathing 
*    Shortness of breath
*    Tightness in the chest.
A person with asthma may have one or more of these symptoms. The symptoms are often worse early in the morning and on waking.

What can trigger symptoms?
Different people with asthma may have different asthma triggers (trigger factors) which may make their asthma worse.

Common triggers include:
*   Colds and flu
*    Exercise (this can be managed)
*    Inhaled allergens (e.g. house dust mites, pollens, moulds, animal hair)
*    Cigarette smoke
*    Cold air or temperature/weather changes
*    Certain medications (ask a doctor or pharmacist)
*    Chemicals, irritants and strong smells
*    Some foods and food preservatives, flavourings and colourings
*    Some occupations (e.g. exposure to chemical, dust and gases)
*    Emotion, stress, anxiety.
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Headaches usually have easily treated causes. Finding the reason for your headaches is important as it could be a symptom of a serious condition. Once the reason for your headache is known, learning how to deal with it can help reduce the frequency of headaches and how painful they are. A doctor or pharmacist can help find the kind of headache you suffer and the best treatments for it.

The four most common types of headache are:

Tension headache - is caused by muscle contractions (spasms) over the neck and scalp, causing pain in these areas. Stress, worry and anxiety, such as pressure at work or a family argument, can cause tension headaches. They often feel like there is a tight band around your head or a weight on top of your head or shoulders.

Migraine - is a severe, recurring headache that may be accompanied by other symptoms such as nausea and vomiting. Often the pain is only felt on one side of the head. They are usually triggered by certain foods or emotions, with some people having warning signs (aura symptoms) up to an hour before the headache starts e.g. flashing lights, tingling or numbness (’pins and needles’) on one side of the body. Often bright lights become very uncomfortable, and any noise causes the headache to become worse.

Cluster headaches - occur in bouts (clusters). The attacks can last for 10 minutes to two hours and may occur again several times in 24 hours. This can happen for weeks or months followed by pain-free periods of months or years. Severe pain occurs behind one eye or on one half of the head, with redness and watering of the eye and blockage of the nostril on that side.

Sinus headache - is caused by increased production of mucus within the sinus, or blockage of the drainage system of the sinus, or both. Pressure builds up within the sinus, causing pain. This pain is felt over the sinus affected area, usually behind and around the eye or over the forehead. Usually only one side is affected. The affected sinus often feels tender and the pain is worse when bending forward or lying down. Sinus headache may be associated with sinus congestion, which may be due to allergy or infection

Trigger factors for headaches
Some people find that certain things start (trigger) their headaches. Triggers are not the same for everyone and they may be different for the same person at different times.

Triggers include:
*    Stress, tension, anxiety
*    Hormone changes e.g. periods, pregnancy, the oral contraceptive pill, and hormone replacement therapy
*   Coffee withdrawal
*   Too much alcohol
*    Fasting, delaying or missing meals
*    Bright or flickering lights
*   Strong smells or fumes
*    Some medicines (ask your pharmacist).

Self care
*    Try to find out what triggers your headaches and avoid them if possible.
*    Keep a simple daily record of your headaches and activities to help find your trigger factors.
*    Plan ahead - rearrange activities to remove stress - let others help
*    Learn to relax
*    Exercise regularly 
*    Get plenty of sleep 
*    Eat a well-balanced nutritious diet (see Nutrition Fact Cards)
*   Wear sunglasses to reduce glare
*   Drink plenty of water before going to bed if you have had too much alcohol.
*    Take regular breaks if you work in the same position all day Make sure you have good posture.

Medicines
Simple pain relievers can help e.g. paracetamol, aspirin, and ibuprofen - ask your pharmacist.
*    For sinus headache - apply a warm, damp cloth over the sinus area, use an inhalation or a decongestant medicine (ask your pharmacist).
*   A doctor may prescribe other medicines for severe headaches or migraines.
*   Take the right dose of medicine at the right time. Your doctor and pharmacist will advise on how much and when.

Important
See a doctor if your headache:
*    Does not ease with over-the-counter pain relievers within a day
*    Is severe and lasts more than four hours
*    Starts after exercise, sex, straining or coughing
*    Disturbs sleep or is present immediately on waking
*    Is worse in the morning then improves
*    Occurs while you are on the oral contraceptive pill
*    Is sudden, severe or is a new type of headache
*    Occurs after a head injury or an accident
*    Onset age is 55 years or older
*    Is associated with:
-    Disturbances in your sight, loss of balance or are vomiting
-    Any neck stiffness
-    Drowsiness, confusion or poor memory
-    Fever, joint and muscle pains.

Headaches in children are unusual and the child should be seen by a doctor, especially if they are frequent or last for more than a few minutes.

Contact:
A doctor - listed under medical practitioners in the yellow pages of the phone book.
A Self Care pharmacist - to find: (02) 6283 4777

In case of poisoning, phone the Poisons Information Centre on 13 11 26 from anywhere in Australia.

Pharmacists are medicines experts. Ask a pharmacist for advice when choosing a medicine.

With some simple planning a traveller can help ensure that any health concerns don’t interfere with the enjoyment of the overseas travel, ensuring a safe trip and healthy return.

Deep Vein Thrombosis (DVT)
DVT is sometimes referred to as ‘travellers thrombosis’ or ‘economy class syndrome’. DVT is the formation of a clot in the deep veins of the leg. Sitting for long periods of time while travelling may be associated with this condition.

Risk factors include:
*    Over 40 years of age         
*    Recent surgery                   
*    Taking hormone therapy   
*    Family history of DVT
*    Blood clotting disorders
*    Certain medical conditions (e.g., heart disease).
*    Smoking
*    Pregnancy
*    Obesity

Symptoms
*    There may be no symptoms
*    Leg swelling and redness
*    A mild ache in one or both legs, particularly in the calves.

Jet lag
The degree of jet lag depends upon the number of time zones crossed and in which direction, east or west. The body clock can take days or even weeks to get used to the local time of a new destination.

Symptoms
*    Anxiety feeling disoriented
*    Forgetfulness, poor concentration
*    Poor appetite, upset stomach
*    Weakness, irritability, tiredness, disturbed sleep
*    Headache
*    Being alert, sleepy and hungry at the wrong times.

Travellers’ diarrhoea (TD)
TD remains the single most common illness affecting travellers. Eating contaminated food or drinking contaminated water or ice most commonly causes TD.

Symptoms
*    Stomach cramps
*    Frequent runny watery bowel motions
*    Sometimes vomiting, fever or bloody bowel motions.

Malaria
Malaria is a serious disease caused by a parasite that infects red blood cells. There are four different malaria parasites. Anyone can get malaria if they are bitten by an infected mosquito in a region where malaria occurs.

Symptoms
*    Fever, chills, sweating        
*    Headache.

The most serious form of malaria can cause organ failure, coma or even death.

Self care

Before leaving
*    Visit a doctor and dentist for a check-up at least eight weeks before travelling.
*    Talk to your doctor and pharmacist about which medicines you need to take with you. It is illegal to carry Pharmaceutical Benefits Scheme (PBS) medicines overseas unless they are for your personal use or the use of someone travelling with you.
*    If you are planning to carry medicines overseas you should: contact the embassy of the country you are visiting, to ensure any medicines are legal there; carry a letter from your doctor outlining the details of the medicines, how much you will be carrying, and stating that they are for your personal use; leave the medicines in their original packaging so they are clearly labelled with your name and dosage instructions.
*    Purchase health and travel insurance.
*    Ensure immunisations are up-to-date — check to see if any special vaccines are needed.
*    Always carry a first-aid kit. Completing a first-aid course and carrying an emergency dental kit may also be useful if travelling to remote areas.
*    Wear a Medic Alert bracelet or necklace if you have a serious health condition or allergy (ask a pharmacist).

DVT
*    Exercise calf muscles half hourly.
*    Drink plenty of water and juice but avoid alcohol and caffeine-containing drinks.
*    If you are in a high risk group for DVT, see a doctor before you travel.

Jet lag
*    If possible break the trip up by including stopovers in travel plans.
*    Try to plan for arrival at the destination around bedtime.
*    Set your watch to the local time of the new destination. Eat and sleep according to this time during the flight.
*    Eat light healthy meals and wear loose, comfortable clothing during the flight.
*    Try to sleep on longer legs of the flight. A mild sleeping tablet may help (ask a doctor or pharmacist).

Travellers’ diarrhoea
*    Drink small amounts of fluid often.
*    Rest and eat starchy foods.
*    Drink only boiled, canned or bottled drinks - don’t add ice.
*    Avoid shellfish and cold cooked meats.
*    Don’t eat fresh salads, raw vegetables or cut fruit — if you can’t peel it, cook it or boil it, don’t eat it.
*    Wash your hands before meals and after each toilet visit. Dry your hands with your own towel or let them air dry.

Malaria
*    Use insect repellent at regular intervals.
*    Use mosquito nets.
*    Cover arms, legs and ankles with clothing when outdoors, especially after sunset.
*    Check if you need to take medicines to reduce the risk of getting malaria (ask a doctor or pharmacist).
*    Ensure you have sufficient anti-malaria medication to last the whole trip.

General
*    If you plan to spend time outdoors, use a 30+ sunscreen and lip balm, particularly in tropical areas or at high altitude.
*    Whether you are male or female take condoms with you rather than rely on those bought locally. Always follow safe sex practices.
*    Travellers on ‘adventure’ holidays will need specialised advice regarding altitude sickness and other health issues.
*    Special preparation may be necessary if you are travelling with children or are over 60 years of age.

On returning
Always tell a doctor if you have been overseas. Some diseases can take many months to show up. See a doctor after returning home if you get:
*    Any fever or flu-like symptoms
*    Diarrhoea that won’t go away
*    Skin problems (e.g., rash)
*    Any other unusual symptoms.

Contact
A doctor—listed under ‘Medical Practitioners’ in the yellow pages of the phone book

Travellers Medical and Vaccination Centre - ph 1300 658 844 or www.tmvc.com.au

MASTA (Medical Advisory Services for Travellers Abroad — ph 1300 655 565 or www.masta.edu.au

A Self Care pharmacy — to locate telephone 1300 369 772 and ask for the Pharmacy Self Care Field Officer.

PBS Overseas Drug Diversion information line — ph 1800 500 147

In case of poisoning, phone the Poisons Information Centre on 131 126 from anywhere in Australia.

Pharmacists are medicines experts. Ask your pharmacist for advice when choosing a medicine.