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St Triduana's Medical Practice54 Moira ParkEdinburgh, EH7 6RUTel: 0131 657 3341
**Please check your repeat prescriptions for any messages from us**
Asthma is a common condition that causes coughing, wheezing, tightness of the chest and breathlessness. Most people with asthma who take the appropriate treatment can live normal lives, but left untreated, asthma can cause permanent damage to the airways. You will be seen by our practice nurse for an annual review.
The usual symptoms of asthma are
Not everyone will get all of these symptoms. Some people experience them from time to time; a few people may experience these symptoms all the time.
There isn't a cure for asthma. However, treatments are available to help manage your symptoms. Your treatment plan will be individual to you, combining medicines and asthma management in a way that works best for you
Medicines are only part of your treatment for asthma. You will also need to deal with the things that make it worse. Keep a diary to record anything that triggers your asthma - this can help you to discover a pattern. Using a peak flow meter to monitor your lung function can also help. If you have repeatedly low readings in a certain situation (for example, at the end of a working day, after exercise or after contact with an animal) this may indicate the trigger.
Asthma UK This website has been revamped to meet the needs of the thousands of people with asthma who visit the site each day, either to find important information about asthma and how to control it
Asthma An excellent resource with useful video, audio, images and references relating to asthma.
NHS Choices - Asthma Further information about symptoms, treatment, causes and prevention of Asthma.
Chronic obstructive pulmonary disease (COPD) is the name for a collection of lung diseases including chronic bronchitis, emphysema and chronic obstructive airways disease. The main symptom of COPD is an inability to breathe in and out properly. This is also referred to as airflow obstruction.
NHS Choices Guide to the symptoms, diagnosis, treatment and risks of COPD from the NHS
COPD Factsheet This factsheet is for people who have chronic obstructive pulmonary disease (COPD), or who would like information about it.
British Lung Foundation Information and guidance on living with COPD
Diabetes is a long-term (chronic) condition caused by too much glucose (sugar) in the blood. It is also known as diabetes mellitus. There are two types of diabetes - type 1 and type 2.
According to the charity Diabetes UK, more than two million people in the UK have the condition and up to 750,000 more are believed to have it without realising they do.
More than three-quarters of people with diabetes have type 2 diabetes mellitus. This used to be known as non-insulin dependent diabetes mellitus (NIDDM) or maturity-onset diabetes mellitus. The number of people with type 2 diabetes is rapidly increasing as it commoner in the overweight and obese, which is itself a growing problem.
The remainder have type 1 diabetes mellitus, which used to be known as insulin-dependent diabetes mellitus.
It's recognised that the sooner the blood sugar levels are brought under control, the better the long term prospects of preventing damage. Lifestyle advice about diet, weight management and regular activity is the first step. After diagnosis the practice nurse will review you annually.
Type 1 diabetes will require immediate insulin therapy, Type 2 diabetes will first be managed with a drug called Metformin, if lifestyle changes alone aren't effective. There are now several other drugs used in type 2 diabetes, although eventually some type 2 diabetics will need insulin therapy as it's a progressive disease
There is further information and education on the Diabetes UK Video Site
Diabetes - Healthtalkonline Healthtalkonline, an award-winning charity website, lets you share in other people's experiences of health and illness. An excellent resource compiled after interviewing a wide range of people suffering from heart disease.
Type 1 Diabetes An excellent resource with useful information and references relating to Type 1 Diabetes.
Type 2 DiabetesA useful resource regarding Type 2 Diabetes.
Diabetes UK Largest charity in the UK devoted to the care and treatment of people with diabetes in order to improve the quality of life for people with the condition
NHS Choices Further information about symptoms, treatment, causes and prevention of Diabetes
These links all come from trusted resources but if you are unsure about these or any other medical matters please contact your doctor or pharmacist for advice.
St Tridunana’s Medical Practice
How to monitor at home and reduce blood pressure
There is increasing evidence that measuring blood pressure at home is a useful and accurate way to assess blood pressure. Below are a few important tips on the correct procedure for monitoring your blood pressure at home, as well as advice as to how to lower it naturally.
It can be scary being diagnosed with high blood pressure. But, if you understand it and take control of it there is a lot that you can do to lower it and to reduce your risk of a heart attack or stroke. Keeping your blood pressure down is a highly effective way of helping to prevent heart attacks and strokes in later life. Imagine the heating system in a house – the lower the pressure the water is being pumped through the pipes, the longer the pipes will last…
If you smoke, this is much more dangerous with high blood pressure and we strongly urge you to stop. We can help you with this. It seems hard, but people succeed at it all the time and then live longer and healthier lives as a result.
► How to monitor your blood pressure at home
Make sure you have a validated monitor with an appropriate cuff size. Click here for a list of validated monitors from the British Hypertension Society. One of these costs just £15. Once you have the monitor, follow these simple instructions:
Measure from the upper arm
Take your blood pressure whilst seated, with your arm and back supported, legs uncrossed and whilst you are not talking (talking and crossed legs increase blood pressure)
Measure your blood pressure in both arms, and if there is a consistent difference of more than 10mmHg then always use arm with higher reading, and let your doctor know.
Take two readings, at least a minute apart, morning and evening for 7 days recording the lower of the two readings onto a sheet of paper or a computer spreadsheet.
The systolic reading is the upper reading (when your heart beats) and the diastolic reading the lower one (in between beats).
Once you have completed 7 days of measurements, calculate the average of all the readings. Your doctor will want to know the average, and also the range from the lowest to the highest readings you have got.
Monitor for a week every 3 months, or every 4 weeks after a change in your medication dosage.
Home BP monitoring form
►What should my ‘ideal’ blood pressure be?
This varies according to your age and other conditions, and your doctor will discuss with you what your individual ideal ‘target’ should be. But, general ‘targets’ for the average of your readings are
If you have diabetes, kidney disease or other conditions these ‘targets’ may be lower. If the average of the readings is OK, but you have some very high readings (e.g. more than 180 or more than 110) then let your doctorr or nurse know.
► How to lower Blood Pressure Naturally
The good news is there is a lot you can do to reduce blood pressure naturally. Even if you are on medication, reducing your BP further through lifestyle change will reduce your risk of a future heart attack or stroke. The research is incredibly strong that regular exercise, losing some weight, relaxation exercises and changing what you eat is very beneficial for your blood pressure. One of the many advantages of home BP monitoring is that you can soon start to see the benefits of making these changes!
To help reduce your blood pressure naturally you should look at:
Regular exercise will reduce your blood pressure. It is important to do at least 30 minutes every day, enough to get you slightly out of breath. Brisk walking is fine and or you may prefer other activities to lower blood pressure. It is important this becomes part of daily life.
If you are overweight, even small amounts of weight loss may improve your BP. Work hard on this and also aim to decrease
Salt, sodium and potassium
Eating a low sodium and low salt but potassium rich diet is very important, and brings rapid benefits in reducing BP
Eat no added salt, and eat mostly low salt foods
This means label watching and looking for <300mg salt per 100g of food whenever possible
For simple information on reducing salt click here and boosting potassium click here
Total and saturated fat and red meats (replace with low fat dairy products, fish and poultry)
Sugar and sweet drinks (enjoy small amounts of plain, dark chocolate as your ‘treat’; this actually helps bring BP down!)
Refined carbohydrate (white bread, pasta etc; switch to whole grain ‘brown’ varieties)
Alcohol (except very modest quantities, less than 1-2 drinks daily)
Excessive caffeine (1 or 2 cups of coffee/tea a day are fine)
And increase fruits, vegetables and whole grains in the diet
For more information on your diet and lowering BP see Blood Pressure UK advice
The DASH diet is a diet plan (low salt, high fruit and veg) which has been shown to effectively reduce BP very quickly, irrespective of weight loss, and books (DASH diet book and DASH diet plan) are easily available
} Relaxation exercises and stress reduction
Relaxation exercises and stress reduction have been shown to reduce blood pressure.
15 minutes of meditative slow breathing (reducing your breathing rate to less than 10 breaths per minute) at least 4 times a week produces sustained reductions in BP.
Mindfulness is a form of meditative relaxation which is helpful for a wide range of stress-induced problems, but which also reduces blood pressure and is highly recommended as a healthy daily practice (See the book Mindfulness: a practical guide to finding piece in a frantic world)
For smartphone users, see the Breathe Away High Blood Pressure app
For more information on high BP see NHS information on high BP
Coronary heart disease (CHD) is a preventable disease that was responsible for the deaths of 88,000 people in the UK in 2008 (British Heart Foundation CHD Statistics 2010). In all, 191,00 died from heart and circulatory disease in the UK. Death rates are highest in Scotland and North of England and lowest in the South of England. CHD is the biggest killer in the country.
There are more videos available on all aspects of BHF and heart disease on the BHF video site
Now you can download and listen to podcasts free from the BHF - either on the move or in the comfort of your own home. We have a few examples below, there is a full list on the podcast page.
Giving Up Smoking
Risk Factors & Heart Disease
"The British Heart Foundation is Britain’s leading charity fighting heart and circulatory disease – the UK’s biggest killer. The BHF funds research, education and life-saving equipment and helps heart patients return to a full and active way of life. The charity relies on donations to continue its vital work."
The BHS recommends that only properly validated BP monitors be used both in the clinic and at home. All the monitors listed on their website have been clinically validated. This means that all the machines, regardless of their cost, give reliable readings when used correctly. Please note that added cost does not equate to added accuracy.
View a list of clinically validated BP monitors
CHD - Healthtalkonline Healthtalkonline, an award-winning charity website, lets you share in other people's experiences of health and illness. An excellent resource compiled after interviewing a wide range of people suffering from heart disease.
CHD An excellent resource with useful video, audio, images and references relating to CHD.
NHS Choices Further information about symptoms, treatment, causes and prevention of CHD.
British Heart Foundation Our vision is of a world in which people do not die prematurely of heart disease. We will achieve this through our pioneering research, our vital prevention activity and by ensuring quality care and support for people living with heart disease.
A stroke is a serious medical condition that occurs when the blood supply to part of the brain is cut off.
Like all organs, the brain needs the oxygen and nutrients provided by blood to function properly. If the supply of blood is restricted or stopped, brain cells begin to die. This can lead to brain damage and possibly death.
Strokes are a medical emergency and prompt treatment is essential because the sooner a person receives treatment for a stroke, the less damage is likely to happen.
The NHS Stroke Act FAST pages offer a great deal of information about stroke, including how to recognise the signs, some real stories of stroke sufferers and advice on how to live your life after a stroke.
Chest Heart & Stroke Charity (N.Ireland)
Chest Heart & Stroke Charity (Scotland)
A transient ischaemic attack (TIA), or 'mini-stroke', is caused by a temporary fall in the blood supply to part of the brain, leading to a lack of oxygen to the brain. This can cause symptoms that are similar to a stroke, although they don’t last as long. A TIA lasts only a few minutes and is usually resolved within 24 hours
As TIAs are serious, it is important that they are always investigated so that appropriate treatment can be given quickly. With treatment from our practice nurse, the risk of a further TIA or a full stroke can be greatly reduced.
Chronic pain is pain which lasts for longer than 3 months. Normally when we injure ourselves, we feel pain – this is useful as it helps us to avoid damaging that part of our body until it has had chance to heal. Chronic pain is different and lasts beyond the normal healing time. We now know that the problem is in the pain-sensing system itself, and the pain is of little use to us.
Chronic pain can be felt in specific parts of the body (legs, arms, back etc.), or everywhere. It may be continuous, or come and go. Sometimes it can get worse very quickly – this is called a “flare-up”
Living with Chronic Pain can affect people in many ways. As well as the physical sensations, there can be changes in activity, mood and relationships. Living with Chronic Pain can be a real challenge and it is important to work together with your healthcare team to treat you as a person, rather than just the pain itself. Chronic Pain can be difficult to treat as not all treatments work for all people – it can take time to find what works best for you.
There is still a lot we don’t understand about pain, and why some people develop pain while others don’t. Sometimes the pain can continue after an injury has healed, but sometimes the pain begins without an obvious injury. Sometimes when nerves are damaged they can become very excitable and sensitive even after they have healed.
While we don’t always know why people’s pain started, we do know that managing moods like stress, frustration, depression and anxiety can help change the sensitivity of damaged nerves, and so lessen the pain. It is the same if someone is distracted, or focussed on an activity.
Everyone’s pain is different, and so how people manage their pain will vary from person to person. The links in the ‘Useful Resources’ section below may help you to make the most of skill-set you already have, or teach you new skills to help you manage your pain.
If you would like to discuss Chronic Pain and how to manage it with a GP, please make an appointment
Most people who experience chronic pain have good days and bad days. Sometimes the pain can get much worse, very quickly and without warning - this is called a flare-up. Flare-Ups are a normal part of chronic pain, and do not mean that your medication has stopped working. It is important to remember that a flare up will always settle down.
Click here for more information about Flare-Ups
Often the best information we get on resources available comes from patients. If you find a helpful resource that is not listed here, let us know so that we can share it with other patients.
Chronic Pain Scotland
This is where to get reliable information and advice about how to help with chronic pain. It has been developed for patients, their carers and the public as well as healthcare professionals. You will also find information provided by local Service Improvement Groups.
The Pain Toolkit helps people all over the world self-manage their chronic pain. It has lots of helpful videos, tips and advice on how to self manage pain, as well as a link to an app which can help you to learn to manage your pain.
Pain Concern (Helpline: 0300 123 0789)
Pain Concern is a charity working to support and inform people with pain and those who care for them, whether family, friends or healthcare professionals. They believe that pain is best faced together by the ‘Pain Community’ of people with pain, their family, supporters and healthcare professionals. They produce information to provide support and raise awareness for those with pain in the form of podcasts, videos, leaflets and a magazine “Pain Matters”. They also run a helpline for those in pain.
Pain Association Scotland
Pain Association Scotland is a national charity that delivers professionally led pain management in the community. The service is specifically designed to target those in the community who are affected by Chronic Pain Conditions. They address the non-medical issues which impact on people’s lives. The service is open to anyone regardless of diagnosis, at any time and provides a high quality staff led community based service for people burdened with all forms of chronic pain.
The British Pain Society
The British Pain Society is the largest multidisciplinary organisation in the field of pain in the UK. The link provides information that may be of use to people living with pain, including a list of UK-based patient organisations, a frequently asked questions section and a suggested reading section.
The NHS Lothian Pain Management Programme is led by a team of Physiotherapists and Psychologists. It is based on the best evidence for managing persistent pain and is considered to be the “Gold Standard” treatment.
Click here for more information on the Pain Management Programme