MEDICAL MATTERS

[Stanley]

I have always asked that question about antibiotics.... can they tell the difference between valuable bacteria helping us to survive and nasties trying to harm us. I have never heard a satisfactory explanation and so whenever possible I have avoided them. It begins to look as though I was right to be suspicious.

[PanBiker]

I will let a biologist answer that but from my part I am thankful that they saved my life on one occasion or at least played a big part in the plan. They have also saved a lot of misery over the years for millions of folk.

[Tizer]

It's always been known that antibiotics are usually not species specific and they will kill `good' bacteria as well as pathogens. They are described as `broad spectrum. The benefits were seen to outweigh the `collateral damage' because the antibiotic could save your life. That balance has been eroded by over-prescribing antibiotics, often for minor infections or almost like a placebo. I once worked with a young woman whose family doctor (remember those?) often prescribed antibiotics for her for minor ailments.

There is currently research into `Programmable RNA antibiotics in the form of short antisense oligonucleotides (ASOs) which promise to achieve precision manipulation of bacterial communities'. Bring it on!

[PanBiker]

Indeed Peter. The medical scientists who worked on the Covid vaccines, (Moderna) can now use some of the same techniques developed to make targeted cancer drugs. The hope is that they can be used in place of some types of chemo currently in use.

[Stanley]

The Diabetes Nurse rang me yesterday to tell me the results of last week's 'MOT' blood and other tests. Every result is spot on including a blood sugar so good that last time it prompted a call from the doctor who said he'd never seen such an improvement before. If you remember I had been silly and was being slipshod with my diet.
I learned my lesson and the nurse says it shows, everything is spot on. I shall order my chicken today!

[Tripps]

Well done with the diet. I had it for two meals this week, and quite enjoyed it. Not sure about it for breakfast though.

Just came back from the Ambulatory Clinic. That's Cambridge posh for "walk in". Quite an achievement on my own. I managed the car park - got the patients' concession endorsed on my ticket and paid with a bank card - (£4.10) . I kept the ticket and noticed they had misread my car Reg number. An R had been read as a W.

I mentioned to the Doctor that I had had a very mild cold for the last week. "There are a lot of viruses about " she replied, "and Covid is currently probably the mildest of them all at the moment".

She said she was happy with my progress. "Can I chance a bit of optimism then " said I.

"Yes" she said.

"Ok I'm going home then, to watch the snooker".

[Stanley]

Well done David. So like me you watched Ronnie being slipshod and paying for it by Letting a brilliant Mark Williams comeback knock him out of the championship. (And get him the prize for the highest break almost certainly.)
Yes, roast chicken and lots of veggies is doing it for me and I shall carry on with the same medicine! One tip, try stuffing your chicken with hot and spicy chicken wings and make sure the chicken has some spices in the gravy. I always roast chillies, tomatoes and whole onions with it as well.

On a pedantic note.... I love the fact that by being so pretentious whoever chose that name for the clinic was guilty of bad grammar. A clinic can be walk in but not walk around which is what the use of ambulatory as a descriptor in the name suggests.
Having written that and confirmed that my assumption that ambulatory means relating to or adapted for walking was correct I noted that Ambulatory Care is the new posh name for out patient care being promoted by the NHS. Perhaps they are powerful enough to shift the goalposts of English Grammar.
This has suddenly become off-piste, I apologise. It should really be in the dialect and word meanings topic.

[Big Kev]

Saw this today at Barnoldswick Medical Centre this morning, absolutely disgraceful.

20230113_104330.jpg

[Stanley]

Not sure if you are referring to the fact that so many missed their appointments or the mis-spelling of December....
Both are disgraceful.......

[Big Kev]

The mis-spelling isn't a good advert for literacy but the 152 missed appointments is appalling. I posted the same picture on the Barnoldswick Talk FB page and there are people actually defending the 'no shows'.
Some are saying they're unable to get through on the phone to actually make an appointment so wouldn't be able to get through to cancel, all I can say is they must be calling at the wrong time of day, not sure why they can't email to cancel. I had to book a blood test this week, phoned the surgery at 16:30 on Thursday, got an appointment for 10:50 on Friday.

[PanBiker]

I think a lot of folk must be very impatient as from memory there is recorded message when you first call. All you have to do though is follow the instructions and hang on a bit, not difficult and I always end up with a short conversation to book a slot. Can't see why the surgery isn't a bit more back to normal though?

[Sue]

I have always asked that question about antibiotics.... can they tell the difference between valuable bacteria helping us to survive and nasties trying to harm us. I have never heard a satisfactory explanation and so whenever possible I have avoided them. It begins to look as though I was right to be suspicious.

This is a complicated issue. Broadspectrum antibiotics can be given without testing for the specific bacteria. This is what we ae usually given as testing for antibiotic sensitivity requires growing the bacteria in the presence of impregnated discs of antibiotics to see which one works. This takes 48 hours to get the best results but 24 hours can work. Thus there is a time delay in treatment. Its the broadspectrum ones that can kill useful bacteria. As the name implies they affect a wide range of bacteria. Those that kill specific types of bacteria are called narrow spectrum

There are many different types of bacteria, based on shape ( round called cocci and long called rods, even these shapes vary and are specific) wether they occur in clusters or always as single cells , the size etc wether they produce spores or not, and the structure of their outer wall. These Specific antibiotics target these differences. And are thus not broad spectrum.

To identify bacteria quickly under the microscope a smear is stained on a glass slide using something called grams stain. This test only takes 5 minutes but requires a trained eye sometimes to see the bacteria under the microscope. Some bacteria stain pink and others purple due to the difference in the cell wall structure. The former are called gram negative and the latter are gram positive . So there are gram positive rods, gram positive cocci, gram negative rods, gram negative cocci. Only gram positive rods produce spores, but not all of them . This initial stain is a good 75% knowing what bacteria are there especially when you know where they are found. Eg G - rods in the intestines, dirty water ( E coli, salmonella), G+ On the skin ( staphylococcus) or in the throat ( Streptococcus)

If they need to be identified further a culture of the bacteria are grown in different sugar solutions to see which carbohydrate they are using. Lactobacillus, a G+ rod grows in milk and uses lactose as its energy source. This takes 72 hours to give a reliable result.

Adding together all of these factors disease causing organisms are now geberally well known though new ones do crop like Legionella

So in answer to your question Stanley, yes good and disease causing bacteria can be identified. As for antibiotics its the broad spectrum ones that can have adverse effects. The narrow spectrum ones as the name implies are very specific but identification and sensitivity does take time. There is no doubt that antibiotics are life savers, but should be used sensibly. Not competing a course of antibiotics encourages resistence to antibiotics.

Resistance is another long and complex topic

[Big Kev]

There is indeed a recorded message Ian. I listened and 'stayed on the line' for anything else, it connected and an automated voice told me there was one other call in front of me, waited a couple of minutes and spoke to a real person. I think a lot of the problem is people phoning for an 'emergency' appointment, it's publicised that these need to be booked at 08:30 or 14:00. I wonder why the lines are busy at these times?

[Sue]

I will let a biologist answer that but from my part I am thankful that they saved my life on one occasion or at least played a big part in the plan. They have also saved a lot of misery over the years for millions of folk.

I didn’t see this and yes I have

[Stanley]

I was talking to a person who is concerned with getting surgery responses for problems with people in care. I was told that the Earby surgery was performing well but the Barlick surgery was giving problems.

[plaques]

More Hosptal trusts to be affected by the nurses strike. Lancashire Teaching hospitals now included, ie: Blackburn and Burnley.
This is the advice from the NHS England ,NHS briefing: Industrial action winter 2023

What if I have an appointment on a strike day?
Everyone who has an appointment should attend as planned, unless your local NHS provider has contacted you to reschedule. If we have not contacted you, please attend your appointment even if your Trust is affected by strikes.

Just my luck I have an appointment on the 19 January. I shall survive.

[Stanley]

Good luck with it Ken....

[Stanley]

Following on my recent triumph in managing to talk to someone at British Gas who seems to have the power to do things....
I have to report another success. I have received word that my prescription is ready at Well pharmacy. I have spoken to them and it is for all three items! Gott Sei Dank! It has taken me 9 months to get to this point.
I shan't go for it until the weather improves a bit

[Tizer]

Seeing Tripps describing his problem with arthritis prompts me to mention one of Mrs Tiz's friends. They met the other day and the friend showed her how she now had one of her fingers bent round into her palm and stuck there. She wasn't doing anything with her hand when she suddenly had a searing pain from her hand right up that arm and found the finger bent into her palm. The doc says it's a ligament problem but lord knows when they'll get around to correcting it, the NHS being as it is now.

Update from Mrs Tiz. Her friend now has an appointment in 4 weeks time, so better than I'd expected. And it's a tendon, not a ligament, which prompted us to consult Collins for the difference between them. A ligament joins two muscles; a tendon joins a muscle to bone. Ligament: from Latin ligare meaning `to bind, tie". Tendon: from Ancient Greek `to stretch'.

[plaques]

Concern is being raised about the mRNA type vaccines of the kind being used to treat covid. mRNA messenger RNA vaccines

People susceptible to an autoimmune response may have an adverse reaction to messenger RNA vaccines

an adaptive immune response that teaches the body to identify and destroy the corresponding pathogen or cancer cells.

The suspicion is that in some people the immune response attacks other areas other than the targeted virus.

This has been mentioned before in OG with reference to Dr John Campbell, but I draw the line at getting Nigel Farage involved.

[Stanley]

"I draw the line at getting Nigel Farage involved."
Very glad to hear that David.....

[PanBiker]

Request text yesterday from the surgery for a weeks worth of AM/PM blood pressure readings. Just added the first one to my spreadsheet. A better picture will be available next week but this first one indicates I am ticking over nicely.

[Cathy]

Some of you might remember that 3 months ago I suffered (and still am) an exacerbation of my back problems, and my doctor put me on a 3 month medical certificate.
Well, today that was extended another 3 months.
This takes me to mid April, which is my retirement date.

I feel ‘unofficially’ retired. Quite strange really, but I’m happy with it.

[Stanley]

That's what happened to me Cathy and also because of my back. I was put on permanent sick leave 12 months before my official retirement date. I have to report I never looked back after that and my back slowly got better to the stage where backache is very unusual.
I wish you the same good luck Cathy!

[Cathy]