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The 12 conditions of Christmas

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The 12 conditions of Christmas

Even the most wonderful time of the year can be plagued by illness and health problems. Pharmacies can be the number one destination for seasonal survival.

The countdown to the 12 days of Christmas has well and truly begun. For most of us this means 12 days of family fun, but winter ailments and a tendency to overindulge can put a dampener on festivities. So if a customer’s true love has given them a bout of flu, a thumping headache, or contributed to an unwelcome bulging waistline rather than golden rings and a partridge in a pear tree, pharmacy teams need to be on hand to help and ensure a happy, healthy Christmas for all.

1. A cold or bout of flu

With over 200 common cold viruses, three types of flu virus and many different strains of each, avoiding them all at this time of year can be virtually impossible. While these viruses can leave us feeling quite unwell, symptoms such as a blocked nose and sore throat will clear up on their own and there’s usually nothing a GP can do to help. It should be stressed to customers that antibiotics will not be effective in treating cold and flu symptoms.

OTC medicines such as paracetamol and ibuprofen can reduce fever and relieve pain, while decongestants help to clear a blocked nose – all-in-one treatments which contain both a painkiller and a decongestant can be particularly handy.

Reena Barai, pharmacist at SG Barai Pharmacy in Sutton, says: “People make the mistake of taking just one dose or having a swig of cough medicine, but patients should take all cold remedies regularly, until they feel completely well. Everyone is different so it’s all about listening to your body, having plenty of rest, if possible, and drinking lots of fluids.” Promoting the flu jab to at-risk customers is also important as it’s the best way to prevent flu.

2. A bulging waistline

Eating, drinking and being merry can be the basis of a great Christmas for most, but it often comes at a price. Rich foods, extra calories and lots of alcohol mean we can put on between one and five pounds (1-2.5kg) in weight over the festive period. This excess isn’t helped by cold weather and shorter days, which can lead to a lack of physical exercise and the allure of comforting, high fat and carbohydrate-heavy foods.

Pharmacies can provide healthy living advice so customers can enjoy the festivities while still taking care of their health. A hearty breakfast with a good source of energy and fibre, such as porridge, is important, as is a balanced diet with plenty of fruit and vegetables – winter greens such as cabbage, kale, spinach and Brussels sprouts, are a great source of vitamins, iron and potassium.

Exercise not only keeps you fit and staves off winter weight gain, it also helps fight fatigue. But exercise doesn’t have to mean a tiring gym session. A long, brisk walk with the family, seasonal activity such as ice skating or even a good bit of housework when preparing for visitors can help achieve the recommended goal of 150 minutes of exercise a week.

3. Norovirus

It is estimated that between 600,000 and one million people in the UK catch the highly contagious norovirus each year, the main symptoms of which are diarrhoea and vomiting. “People need to be made aware that norovirus is circulating and be encouraged to maintain good hygiene to give themselves the best chance of not contracting it,” says Reena.

“If someone is unlucky enough to come down with it then, as it’s a virus, it will clear up on its own in a couple of days. Symptomatic treatment is needed, so light meals, plenty of fluids and rehydration sachets if it’s particularly bad.”

People should stay at home until symptoms pass. If advice or OTC products (e.g. rehydration sachets) are needed, customers should ring their pharmacy to ask about delivery services or get someone to go for them.

4. Cold sores

Cold sores are small, fluid-filled blisters that develop on the lips or around the mouth thanks to the herpes simplex type 1 virus. This virus stays dormant until triggered by cold weather, the person feeling run down, having another infection such as a cold or flu, or feeling stressed. Cold sores are very infectious, especially when they’re at the blistering stage, but they usually clear up on their own within seven to 10 days.

An OTC antiviral cream can be used to ease symptoms and speed up healing time. This should be applied as early as possible (when the cold sore is at the ‘tingling’ stage) and creams should be applied regularly, being dabbed onto the cold sore rather than rubbed in. Applying lip balm to keep lips moisturised can also help.

5. A hangover

For some, Christmas festivities can lead to drinking much more alcohol than the recommended three to four units for men and two to three units for women per day. A single pint of beer or large glass of wine can easily contain two or three units, so it can quickly add up.

Alcohol affects everyone differently, but for most, feeling worse for wear the next day is a common side effect. Although many hangover cures have been suggested over the years, scientific evidence for their effectiveness is generally lacking. Of course, the best way to avoid a hangover is not to drink, but if people do indulge then they should be encouraged not to drink on an empty stomach and to drink plenty of water.

Dehydration is one of the most common side effects of drinking alcohol and leads to the tell-tale headache. Rehydration can help reduce unwanted symptoms, and OTC painkillers can help relieve a headache. Paracetamol is often preferable as ibuprofen can irritate the stomach.

The old tradition of the hair of the dog – drinking more alcohol – is likely only to delay a hangover, so is best avoided.

6. Asthma

A survey by Asthma UK revealed that cold or snowy weather triggers symptoms in 76 per cent of people with asthma, as it can make the airways hypersensitive. When going outside in cold weather, asthma sufferers should be advised to wrap a scarf loosely around their mouth, breathe in through their nose to warm the air as it’s inhaled, carry reliever and preventer inhalers at all times and use them as prescribed. If symptoms worsen and inhalers are needed more often, patients should speak to a GP.

Cold weather isn’t the only Christmas-time trigger, according to the survey, with unpacking dusty decorations (58 per cent), stress (47 per cent), smoke from open fires (46 per cent), strong fragrances from perfume (40 per cent) and scented candles (40 per cent) all triggering asthma symptoms.

Amena Warner, nurse practitioner at Allergy UK, says: “During the winter, we spend more time indoors hiding from the cold and wet weather and we can become more susceptible to certain triggers like mould – which can develop in damp conditions – dust mites and pets.” Asthma should therefore be managed in a very proactive way, especially in children. “If you know your triggers then reduce them,” says Amena.

“For example, eradicate mould in the home or if it’s a house dust mite trigger then you need to take reduction measures such as washing bed clothes at 60°C. For lots of people these measures make a big difference, but if they don’t, they should get a referral to a secondary care clinic where additional treatments are available.”

 

Christmas top tips

Reena Barai, pharmacist at SG Barai Pharmacy in Sutton, has these top tips to pass on to customers at Christmas:

  • Be prepared for every eventuality: you might have children or older people coming over for Christmas, so make sure the medicine cabinet is stocked up with these people in mind, as well as your usual painkillers and remedies
  • Maintain good hygiene: especially if you’re preparing meals and feel unwell. This will stop bugs spreading around the house and to other people
  • Think pharmacy first: if in doubt about any symptoms, phone the local pharmacy for advice or pop in – seasonal opening times should be clearly advertised. It’s also important to make it clear about alternatives for when the pharmacy is closed, such as NHS Choices or the non-emergency 111 number where people can talk to a trained healthcare adviser about symptoms and what steps they should take.

 

7. Seasonal affective disorder

As many as two million people in the UK are affected by seasonal affective disorder (SAD). A form of depression, SAD commonly occurs in winter months and significantly impacts how sufferers live day-to-day. It’s characterised by a lack of energy, sleep problems, feeling hopeless, numb or apathetic and anxious.

It can also manifest itself in the immune system, making sufferers susceptible to illnesses and aches and pains. Rachel Boyd, information manager at the mental health charity Mind, says: “The positive thing about SAD is that for lots of people it can be quite predictable. It’s often possible to recognise a pattern of behaviour which gives you the chance to build resilience around yourself.”

Self care is important for preventing and treating SAD. This includes being up and active in daylight hours, letting as much light as possible into living spaces, exercising, eating a healthy, balanced diet and avoiding stress as much as possible.

“There’s also medication, so taking antidepressants or St John’s wort, which is a herbal over-the-counter remedy. Light boxes are another big treatment and, although research about their usefulness hasn’t drawn clear conclusions, many people find they do help,” says Rachel. But she believes the most important thing is for patients to get to know themselves and the signs of their SAD, as well as building a support network. “So whether that’s friends and family or healthcare professionals, they can help you to see the signs, recognise your vulnerability and be there for you to talk to when you’re feeling particularly low.”

8. Sore feet

Whether it’s because of dancing all night at the Christmas party or going for long walks with the family, this time of year can take its toll on feet. The run up to Christmas is ideal for promoting footcare products and encouraging customers to give their feet some TLC.

Pharmacy teams can also be on hand with advice. For example, when wearing high heels, the College of Podiatry recommends putting the heel down first to minimise damage, and stretching out the calf, heel and foot muscles during and after wearing them to increase circulation and help muscles relax.

Blisters, corns, callouses and bunions can usually be easily treated with OTC products and self care – for example, to tackle a build up of tough, dead skin, soak feet in warm water for 10 minutes, buff away the skin with a pumice or foot file and apply a moisturising cream. A product containing urea will be particularly hydrating. If foot problems persist, despite OTC treatment, advise customers to visit a podiatrist.

9. Constipation

Not passing stools regularly, being unable to completely empty the bowel, stools being hard and lumpy or unusually large or small, are all signs of constipation. It usually results from a change in routine or lifestyle, such as eating habits, or not eating enough fibre, which often happens around Christmas time. Generally, initial treatment includes slowly increasing fibre intake, drinking plenty of fluids, and exercising. If these don’t help, OTC laxatives are available.

10. Indigestion

Many people will get indigestion over the Christmas period thanks to the richness and quantity of foods eaten. Eating too quickly and drinking alcohol can also contribute. Symptoms include pain or discomfort in the abdomen, bloating, belching, feeling overly full, nausea and vomiting.

Most people can control symptoms easily with OTC tablets or liquids. Eating healthily, losing weight if necessary and cutting down on smoking and alcohol can also help long term.

“OTC indigestion remedies can help alleviate symptoms, but if they find they have to use it after every meal, or if they’re feeling constantly bloated or experiencing acid reflux (regurgitation) despite taking the medication then it’s important that customers see their GP,” explains Reena.

11. A headache or migraine

Everyone gets the occasional headache and for some people, they can be particularly bad during the winter months. “Cold weather, stress, alcohol and some foods such as chocolate can all trigger headaches and migraines so they’re especially prevalent this time of year,” explains Reena.

Although headaches can be a nuisance, they’re easily treated. “The key is to know your triggers and recognise the initial signs of your migraine or headache. This means you can take medication at the onset, which is beneficial as it has a better chance of working the earlier it’s taken. OTC painkillers can usually clear it up and patients can discuss the options with pharmacy staff. Some varieties have anti-sickness medicines in them so can help if that’s a symptom you suffer with,” says Reena.

12. Eczema

Affecting about 10 per cent of adults and 20 per cent of schoolaged children, eczema is characterised by inflammation of the skin, itching, scaling, dryness, and cracking and weeping skin in severe cases. “Cold weather can contribute to the skin drying out more and many people think staying indoors is the best solution but actually it’s not,” explains Amena. “House dust mites enjoy high temperatures and thrive in those conditions, so by turning the heating on they become problematic for people allergic to them,” she adds.

She therefore recommends that patients with eczema follow a preventative pathway to reduce exposure to potential triggers: “The best thing to do is not to have the heating up so high, wear non-irritant clothing such as cotton against the skin and regularly moisturise,” she says. “People have to be careful about choosing a moisturiser as some perfumes and fragrances can irritate the skin. Lots of products are endorsed by dermatologists, and pharmacists can really help by pointing people towards these types of products.”

 

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