NHS referral service

Ear Wax

• Ear wax is normal it provides protection for your ears
• Your ears are self-cleaning
• The movement of your jaw while eating and talking moves the wax along the canal
• Ear wax only becomes a problem if it causes deafness, pain or if a health professional
  needs a clear view of the ear drum

What makes ear wax worse?

• The amount of wax produced varies from person to person
• Some people produce excessive amounts of wax and this can block the ear canal
• Wearing a hearing aid, ear plugs and or head phones can interfere with wax expulsion
• Narrow and or hairy ear canals
• If you are elderly – the wax produced may be harder and drier
• Dry skin in people who suffer with eczema or psoriasis

What you shouldn’t do

• Use cotton buds to clean the ear. This forces the wax deeper into the canal and can cause damage, trauma and possible infection
• Do not use objects such as matches, hair grips, crochet hooks, knitting needles, keys etc. this can cause trauma and possible infection
• If your ears are itchy do not scratch or rub them with your finger nails or any other objects
• Do not use anything smaller than your elbow in your ear!!

What helps?

• Try and keep your ears dry. When washing your hair, showering or swimming putting some Vaseline around the inner part of your ear can help
• Don’t put your head under the water when bathing
• If you regularly get blocked years, use olive oil drops weekly

When to see the GP or Advanced Nurse Practitioner

If you are experiencing the following symptoms:

• Pain
• Discharge or bleeding from the ear
• Sudden deafness
• Dizziness
• Foreign bodies (you may be advised to attend A&E)

What you can do to manage the problem?

• If you are not experiencing any of the symptoms on the previous page, the following is recommended:
• Olive Oil Drops – The following needs to be done 2 -3 times daily for 14 days.

1. Lie on your side with the affected ear uppermost
2. Pull the outer ear gently backwards and upwards to straighten the ear canal
3. Put 2 -3 drops of olive oil into the affected ear(s) and gently massage just in front of the ear
4. Stay lying on your side for 10 minutes to allow the wax to soak up the oil.
5. Afterwards, wipe away any excess oil but do not plug your ear with cotton wool as this simply absorbs the oil
6. Your hearing problem may initially worsen after first starting to use the olive oil drops; this is why you are advise d to concentrate on treating one ear at a time if both ears are blocked with wax.
7. In most cases, after 14 days, the wax will have softened sufficiently to encourage the wax to come out without further intervention.
8. However, if you feel your hearing is still impaired, please make an appointment with the practice nurse for further advice and management.

Alternatively

There are now a number of over-the -counter kits available from pharmacies. These contain a wax softener as drops which you use for 3 -4 days and a small bulb syringe to enable you to remove the wax from your ear canals yourself. They can easily be purchased from your pharmacy or online by searching for ‘ear bulb syringe’ e.g. aculife bulb ear syringe, otex express combi pack or macks wax away earwax removal system for examples.

The specially designed ear syringes are designed to create enough pressure to clear wax out of the ear without causing damage to the ear drum. It is very important to use hand -temperature, tepid body temperature water for this process having used olive oil or the drops in the previous days. Prolonged use of the drops in the over-the-counter preparations other than olive oil can cause irritation and soreness and should not be used for more than a few days at a time.

The nation is getting fatter and the health problems are getting bigger with it. Advice is available on: www.foodfitness.org.uk

Health Eating

When it comes to a healthy diet, balance is the key to getting it right. This means eating a wide variety of foods in the right proportions, and consuming the right amount of food and drink to achieve and maintain a healthy body weight. The ‘Eatwell Plate’ highlights the different types of food that make up our diet, and shows the proportions we should eat them in to have a well-balanced and healthy diet.

Exercise

Exercise is essential to maintain both mental and physical wellbeing. Being active in your daily life at every opportunity will play a key role in this.

NHS guidelines state that to stay healthy, adults aged 19-64 should try to be active
daily and should do: at least 150 minutes of moderate aerobic activity such as
cycling or brisk walking every week, and. strength exercises on two or more days a
week that work all the major muscles (legs, hips, back, abdomen, chest, shoulders
and arms)

For more information the NHS Live Well page.

If you are struggling with your weight and eating habits please make an appointment
to see a Nurse or a Health Care Assistant at the Surgery & they will be able to help
you.

Park Run 

We are a Park Run practice!

What is Park Run?

Parkruns are free, weekly, community events held all around the world

5k events are held every Saturday morning in areas of open space

2k junior parkruns for 4-14 year olds and their families are held on Sunday mornings

Why join a Park Run?

Over 850 locations across UK

Organised by local volunteer teams

Walk, run, jog, volunteer or spectate – take part in any way that suits you

You can learn new skills and enhance your health and happiness in the great outdoors

Make new friends, feel part of your local community and improve your fitness

Open to all, including those who are inactive or have health conditions or disabilities

Park Runs in Bath

Bath Skyline parkrun

Every Saturday at 9:00am

The event takes place at ‘Free Fields’, North Road/Claverton Down Road (opposite Shaft Road), Bath

https://www.parkrun.org.uk/bathskyline/

Bath Odd Down junior parkrun

A 2k event for juniors only (4-14 year olds)

Every Sunday at 9:00am

The event takes place at Odd Down Sports Ground, Chelwood Drive, Bath, BA2 2PR

https://www.parkrun.org.uk/bathodddown-juniors/

If your BMI is over 30 then you may benefit from some weight loss. Even losing just 10% of your body weight will bring about marked health gains.

There is plenty of advice out there, you can start at the NHS website. Better Health - NHS (www.nhs.uk)

What can we help you with at the surgery?

Sadly we don’t have any magic answers or pills and we don’t prescribe the weight loss medications you may have heard about such as Wegovy. These can be prescribed on the NHS but only to diabetics and are normally initiated by the RUH or specialist.

Occasionally we will prescribe ‘Orlistat’ which is basically a medication that gives you diarrhoea and bloating if you eat fat- so it acts as a deterrent to keep you on course.

But we would argue that a healthy diet, including a weight loss diet, needs to include some fat, so this isn’t that helpful.

The usual advice is to create a calorie deficit but this doesn’t work for everyone and it is more important to switch to healthier foods if you can and change your lifestyle.

If your BMI is over 30 and you would like to be referred to the local Health lifestyle service provided by HCRG (formerly Virgin care) for advice and support, then you can make an appt to see or speak to one of our HCAs who will be happy to make the referral for you. We do need an up-to-date weight and height for this. You can use the machine in our waiting rooms for this if you can’t come in for  an appointment.

The NHS also offers weight loss advice via the NHS website Better health website:

Better Health - NHS (www.nhs.uk)

If you have diabetes or hypertension (are on BP medications) then we can refer you to the NHS digital weight loss service. Please contact us asking for a referral. We will need an up to date height and weight.

If you have prediabetes, we can refer you to the prediabetes education programme which is designed to promote weight loss- this protects against progression to diabetes.  Please contact us asking for a referral. We will need an up to date height and weight.

If you have type 2 diabetes we can also refer you to the diabetes education programme which also promotes weight loss to improve blood sugar control.  Please contact us asking for a referral. We will need an up to date height and weight.

If your BMI is over 40 with diabetes, hypertension or other significant co-morbidities, or over 50 without these, and you have tried the usual weight loss methods- slimming world/weightwatchers, dietary advice, increase in activity, then you may wish see and speak to a GP about a referral to the hospital weight loss services. This is for individuals who are at severe risk from their weight and who wish to be considered for bariatric surgery. This is a long process and at times these NHS services have been suspended due to lack of capacity. At the time of writing we are able to refer individuals with serious co-morbidities only.

If you have concerns about a young person’s weight (under 17) then please make an appt for them to see a GP to make an assessment and advise on options for support.