Asthma is a very common condition affecting around 3 million people in the UK. It can affect children and adults of any age. The majority of people will have only mild occasional symptoms though severe attacks may require hospital admission.

Asthma cannot be cured but with the correct treatment from us and with a little input from you, you should be able to participate in activities and enjoy life without hindrance from your asthma.

Kit Lister is our asthma nurse and has been trained in asthma care and will help you learn to manage your asthma.

For more information visit the National Asthma Campaign - www.asthma.org.uk

Cardiovascular disease is the medical term for heart attacks, strokes and other diseases of the circulation. These are serious conditions that are common causes of both death and disability.

In some cases cardiovascular problems run in families but there are lots of other risk factors involved, which the practice team, with your help, can modify. Sophie Tokatly runs our heart disease treatment and screening clinic on a Thursday morning. She is able to help people who already have problems but can also assess people who have not yet had problems to help you reduce the chance of having a heart attack or stroke.

We operate a recall system for this clinic and will routinely contact you when your appointment is due. If however you wish to make your own appointment please contact reception.

For further information visit the British Heart Foundation - www.bhf.org.uk

The surgery provides the full range of childhood immunisations. You will be contacted when your child is due to have an immunisation. Immunisations are due at the following ages:

When to immunise What is given How it is given
two, three and four months old Polio
Diphtheria, tetanus, pertussis and Hib (DTP-Hib)

Men C

By mouth
One injection

One injection

13 months Measles, mumps and rubella (MMR) One injection
16 months Measles, mumps and rubella One injection
Three and a half to five years (pre school) Polio
Diphtheria, tetanus and acellular pertussis (DtaP)

By mouth
One injection

The practice strongly recommends that your child is protected against these diseases.

Vaccine reactions

These are normal reactions after receiving injections for immunisations against any illness and will occur in adults and children alike. They can take two forms:

1. Pain, redness and swelling at the site of the injection. This can be relieved by the application of an ice pack (a small bag of frozen peas wrapped in a tea towel makes a convenient ice pack).
2. A cold like illness which can occur up to 10 days after the vaccine is given and up to four weeks after MMR.

For more information on immunisations visit www.immunisation,org.uk

Diabetes is a condition in which the body has problems regulating its blood sugar (glucose) level. It is a common condition affecting about 2% of the population. It can begin at any age. Some diabetics will need to be treated with injections but the majority of people will be able to control their diabetes with diet, tablets and lifestyle changes.

If not properly treated diabetes can have very serious complications and so should never be regarded as mild, but with monitoring, treatment and self-help the risk of complications can be dramatically reduced. Our aim is to help you lead a normal and active life and to give you the help, support and advice you will need to help you achieve this.

Our practice nurse, Alex Demery, is trained in looking after diabetics and we will soon be running specialist diabetic clinics to help us improve the service we offer our diabetic patients.

For more information about diabetes visit the diabetes website: www.diabetes.org.uk

A healthy diet is important to help reduce the risk of heart attacks, strokes, circulation problems and diabetes. This should include five portions of fruit or vegetables a day, and plenty of fibre e.g. wholemeal bread, wholegrain cereals (rice and pasta) and a low content of animal fat. Foods high in animal fats are butter, margarine, cream, cheese and red meat, and these should be used in moderation.

If you would like more information or have special dietary needs, the practice has a dietician who visits the practice once a month, or you can discuss it with any of the doctors or nurses.

Our health visitors are Helen Martrosssian and .................. They have been trained to promote good health and detect health problems. Helen and Rebecca are based in the Arndale Clinic in Wandsworth. They run a drop in clinic on a Friday morning and a child health development clinic on a Monday afternoon by appointment.

They can give advice on all aspects of child care including sleeping, feeding and advice on minor ailments. They will visit you at home after the birth of your baby and will arrange appointments for the developmental checks.

To contact the health visitors you can leave a message for them at the surgery or contact them at the Arndale Clinic on 020 8700 0160.

All of the Doctors are happy to look after pregnant women and provide ante-natal care. Ante-natal appointments can be booked in routine surgery. We are able to book people for NHS delivery at St George's, Kingston or Chelsea and Westminster hospitals. Ante-natal care is usually shared between your GP and hospital midwives.

For further information regarding pregnancy and childbirth contact the National Childbirth Trust, www.pregnancyandbabycare.com

Southfields seems to have a large number of twins and multiple births (perhaps something to do with the water!!) If you are expecting twins (or more) further information is available from TAMBA (Twins and multiple births association) www.tamba.org.uk

The menopause is often a time of great change for women. These changes may be social such as childbirth, leaving home or retiring from work. There are often physical changes, changes in periods, hot flushes and aching joints and these may be accompanied by emotional changes such as forgetfulness and changes in sex drive and sleep patterns and tearfulness.
All of this can make the menopause a difficult time for women. If you are having problems or even if you haven't, but would like more information about HRT and alternatives make an appointment in our Monday evening Well Women Clinic or contact the Amarant Trust Helpline 01293 413 000.

The surgery provides a full range of minor surgery services. We are able to treat warts and verruccas by freezing (cryotherapy). We are also able to remove moles, lumps and bumps and remove ingrowing toenails.

Please make an appointment with Dr Kandasamy to assess whether the practice is the best place for your minor surgery or to have your wart or verrucca treatment.

YOUR CHILD AND THE MMR IMMUNISATION

Parents are naturally concerned by reports in the media of side effects associated with the Measles Mumps and Rubella immunisation (MMR).

In view of this, the Doctors in this practice thought it advisable to set out their views to help parents in coming to a decision of whether or not to accept protection.

Nothing in life is without risk. Deciding not to immunise your child against MMR is almost always more risky than deciding to immunise.

Before the measles vaccine was introduced, about 90 children a year died in the UK. We risk returning to this situation if more and more children are unprotected, because of a drop in vaccination numbers.

The rare but major complications such as brain damage (encephalitis), deafness, bowel disease or damage to the unborn child are what most people fear. The risk of all these problems is far higher with the natural infection than with immunisation. There is still no proof that autism is associated with the natural measles virus, even less so with immunisation.

If you still have concerns, please can we suggest that you read the Department of Health Leaflet entitled "A second dose of Measles, Mumps and Rubella Vaccine" For those who wish for more detail and references, please read MMR fact sheets 1 & 2. Copies of these are available from reception. If you still have queries after this, please make an appointment to discuss this with one of the Doctors.

Of course we respect your parental right to make decisions for your children. Obviously it is better if it is an informed decision rather than one based on misinformation or media hype. All the Doctors in this practice have had their own children immunised.

As with all immunisations, if your child has them anywhere else, please inform Linda Hicks, our Practice Manger, of the dates, because it is important that we keep your child's records up to date.

Please see our list of services provided at the surgery.

The surgery holds a well women clinic every Monday evening run by Dr Kandasamy and our nurse Alex Demery. We provide a comprehensive and fully confidential service.

We are able to advise on all methods of contraception including coil fitting, cap fitting and provision of condoms. We can also provide advice about prevention and testing for sexually transmitted infections and counselling for sexual problems.

Contraceptive advice and emergency contraception can also be obtained during ordinary nurse's appointments.

For more information about contraception visit the family planning association web site, www.fpa.org.uk

We all know that smoking is bad for us and that giving up smoking is hard work. The good news is that we can help you give up. We don't have a magic wand but quitting and remaining a non-smoker will still require will power and determination, but we can make things easier.

• Stopping smoking is the best thing you can do for your current health.
• It is never too late to stop smoking
• A 20-a-day smoker can save £1500 a year by stopping.

How to stop smoking

• Set a realistic quit date and stick to it.
• Use Nicotine Replacement Therapy(NRT) Your pharmacist can help you decide which product to use, or take Zyban if your doctor has prescribed it.
• Don't have just one cigarette because it usually leads back to regular smoking.
• Get rid of all unused cigarettes and throw away your ashtrays.
• Ask people not to smoke around you and never buy, hold or light cigarettes for others.
• Tell every one you are stopping - you are going to need their support.
• Do something active when the urge hits.
• Change your routine so you have something else to do at times and places you used to smoke.
• Remember that it will probably take you a while to get used to being without cigarettes. It gets easier as time goes on.
• For more information please make an appointment with the nurses or the doctor.

Information, help and support are available from the:

NHS Helpline on 08001690169

Merton, Sutton & Wandsworth Stop Smoking Service on 02087250981

www.exchangehealthinfo.org

Don't give up giving up

We offer the vaccinations listed below.
Some are available under the NHS.

Some are not covered by the NHS and so we charge for giving them.

You will need to make an appointment with one of the nurses, who will advise and guide you, AT LEAST 4 WEEKS before you intend to travel, as some vaccinations need booster doses and some take time to build up immunity.

However it is better to have the vaccination even if your departure is imminent.

Please note the Doctors do not give travel vaccinations.

NHS Vaccinations - the following vaccinations or combinations are available free:

Tetanus First Hepatitis A

Typhoid Polio

Diphtheria

Non NHS Vaccinations - the following are not available on the NHS and the listed charges apply.

Hepatitis A booster £20

Hepatitis B £15 or £45 for a course of 3 injections

Meningitis £20

Malaria(private prescription) £12

Multi destination malaria advice £10

Rabies(course of 3 injections) £100

All fees to be paid at the time of vaccination.

Cheques to be made payable to Dr Carolynne Christie.

Malaria

There are a number of drug regimes available.

The best one to use varies with the destination and time of year you are travelling.

You should discuss this with the nurse. If you need a private prescription she will arrange it. If a doctor is available to sign the prescription you can take it with you. If not you can collect it 48 hours later.

You then also have to pay the chemist the cost of the drug.

Private companies

If we are unable to meet your vaccination needs you may wish to try a private company. You should note that their charges are significantly higher than ours and the one we offer free under the NHS they will charge for.

Sterile Dressing Packs

These are available from the nurse at a cost of £12.

They contain the following:

1 pair latex gloves 6 pre-injection wipes

1 pack skin closures 1 4/0 suture

1 non adherent dressing 10cm 1 non adherent dressing 5cm

2 needles 21g 2 needles 23g

2 needles 25g 3 syringes 2ml

3 syringes 5ml 1 infusion canula

1 dental needle