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The Afternoon Show
The Afternoon ShowRTÉ One, Weekdays, 4.00pm

Common Summer Ailments With Dr. Philip

Monday, 18 May 2009

Dr. Philip will be speaking about four ailments and their treatments. The ailments are,
. Asthma
. Hayfever
. Sunburn
. Stings

Asthma - Stats:
. Asthma affects over 470,000 people in Ireland
. That translates to one in eight people in Ireland
. It kills at least one person per week in Ireland
. A third of those who die are under the age of 40 in Ireland

What is Asthma?
Asthma is a condition that affects the airways-the small tubes that carry air in and out of the lungs. In asthma, the airways become over-sensitive and react to things that would normally cause no problem, such as cold air or dust. Muscle around the wall of the airway tightens up, making it narrow. The lining of the airways gets swollen (just like your nose during a cold) and sticky mucus is produced, clogging up the breathing passages. With the airways narrowed like this, you can see why it becomes difficult for air to move in and out and why the chest has to work so much. Tightening of muscle around the airways can happen quickly and is the most common cause of mild asthma. It can be relieved quickly too, with the right inhaler. However, the swelling and mucus happen more slowly and need different treatment. They take longer to clear up and are a particular problem in serious episodes of asthma.

What causes Asthma?
No one knows exactly what causes asthma. What we do know is:

. Anyone can develop asthma. It is very common in Ireland, where over 470,000 adults and children have asthma.
. It can start at any time of life, although it most often begins in childhood.
. Sometimes it affects several family members e.g. if you have parents or brothers and sisters with asthma or allergy (e.g. Eczema or hay fever) you are more likely to have it yourself.
. Conditions like hay-fever, eczema, or hives, which are usually the result of allergy, may occur along with Asthma.
. Adult onset asthma may develop after a viral infection.
. Many aspects of modern lifestyles such as changes in housing, diet and a more hygienic environment may have contributed to the rise in asthma over the last few decades.

Asthma Symptoms
The usual symptoms of someone with asthma are: (of which you may experience one, a few or all symptoms)

. Difficulty in breathing/Shortness of breath.
. A tight feeling in the chest.
. Wheezing (a whistling noise in the chest).
. Coughing

These symptoms may occur in episodes, perhaps brought on by colds, exercise, change of temperature, dust or other irritants in the air, or by an allergy e.g. pollen or animals. Episodes at night are common. A few people have these complaints all the time. You need to see your doctor, who will check that there is not some other explanation. By examining your chest, doing breathing tests and listening to your description of symptoms, the doctor can usually decide if you have asthma and can prescribe some suitable treatment.

What to do in an Asthma Attack
Occasionally an asthma attack may occur no matter how careful you are about taking your asthma treatment and avoiding triggers. An asthma attack normally doesn't occur suddenly; most people find that asthma attacks are the result of a gradual worsening of symptoms over a few days. If your symptoms are getting worse, do not ignore them. Quite often using your reliever may be all that is needed to get your asthma under control again. At other times symptoms are more severe and more urgent action is required.

The Five Minute Rule
The Five Minute Rule contains the recommended steps to follow in an asthma attack

1. Ensure the reliever inhaler is taken immediately. This is usually blue and opens up narrowed air passages.
2. Sit down and loosen tight clothing.
3. Stay calm. Attacks may be frightening and it is important to stay calm.
4. If there is no immediate improvement continue to take the reliever inhaler every minute for five minutes or until symptoms improve: two puffs if MDI/evohaler or one puff if turbohaler.
5. If symptoms do not improve in five minutes, or if you are in doubt, call 999 or a doctor urgently. Continue to give reliever inhaler until help arrives or symptoms improve.
Do not be afraid of causing a fuss, even at night.

If you are admitted to hospital or an accident and emergency department because of your asthma, take details of your treatment with you. You should also make an appointment with your doctor or nurse after you are discharged from hospital, so that you can review your asthma treatment to avoid the situation rising again.


Hayfever -It's estimated that up to 15% of Irish people suffer from hayfever.

What is hay fever?
For almost 15 percent of the Irish population, outdoor enjoyment of the summer months is blighted by hay fever. Also known as seasonal allergic rhinitis, hay fever is a very common condition caused by an allergic reaction to pollen or, less commonly, to mould spores. It affects the upper respiratory passages - nose, throat, sinuses - and also the eyes, causing a blocked nose; watery, itchy eyes; constant sneezing; headaches and depression

For many students, the most stressful time of the year - exam time - is made worse by hay fever. Symptoms can last for the duration of the summer but treatment and preventative measures can help significantly.

In Ireland, the majority of hay fever sufferers are allergic to grass pollen, which is at its highest during May to August, peaking in June and early July. Pollen counts are highest in early morning when plants and flowers first release pollen and in late evening when the air begins to cool.

Who is at risk?
If you have a family history of allergic conditions such as asthma or eczema, you have an increased risk of suffering from hay fever because you are more likely to be hypersensitive to allergens (substances that cause allergic reactions).
Hay fever commonly presents in childhood and adolescence. Symptoms tend to improve with age; most people notice a reduction in symptoms as they enter their 30s and 40s.
Although hay fever seems to be less common in towns and cities than in the countryside, city dwellers can suffer just as much from hay fever. In fact, the high level of air pollutants in cities, when combined with pollen, can make hay fever symptoms even worse.

What causes hay fever?
A small number of weeds that depend on wind rather than insects for cross pollination, as well as certain grasses and trees, produce sufficient quantities of pollen for wide distribution by air and are the most common cause of hay fever.

. Grass pollen. High levels of pollen in the summer.
. Tree pollen. Trees such as elder, elm, hazel and birch produce high levels of pollen in the spring
. Mugworth. High levels of pollen in the autumn

When the nose, throat and sinuses of susceptible individuals are exposed to pollen, special white blood cells produce antibodies called IgE (immunoglobulin type E). IgE prompts the release of histamine and other chemicals, which are responsible for the symptoms of hay fever.

If you are prone to hay fever, it is advisable to keep a close eye on the pollen count forecast. Symptoms usually begin when the pollen count exceeds 50.

What are the signs and symptoms?
Depending on conditions and the type of pollen/spores you are allergic to, symptoms may be mild or severe. In severe cases, life can be miserable during the high pollen season.

. The lining of the nose and sinuses becomes swollen and secretes mucous, causing a stuffy, runny nose and a loss of your sense of smell.
. The inside of your nose and ears may also feel tickly.
. The eyes become inflamed and watery.
. The presence of the allergen in the upper airways causes sneezing.

How can I help prevent hay fever?

. Avoid exposure to the allergen that triggers your allergic reaction.
. Keep away from long grass and freshly mown lawns. Do not mow the grass yourself.
. Keep the windows closed during the pollen season, especially mid-morning and early evening.
. Listen out for announcements of the pollen count.
. Use an air conditioner or filter when possible
. Take appropriate medication.


What is sunburn?
Sunburn is an inflammation of the skin due to over-exposure to the sun's ultraviolet (UV) rays.
Most of the sunlight's damage to the skin is caused by the ultraviolet B (UV-B) rays, which have long been known to hurt the skin. UV-B rays penetrate through to the lower layers of the skin, damaging skin cells. While melanin, a dark pigment in the upper layers of the skin, can protect the skin from some of the effects of UV rays, different people have different amounts of melanin in their skin. This explains why some people get burned easier than others.

What kind of damage can sunburn cause?
Other than the immediate pain and discomfort, sunburn can also cause long-term damage. It can increase a person's chance of developing skin cancer. Repeated overexposure to the sun can also cause your skin to age prematurely, giving it a leathery appearance.

Home Care
Sunburn is better prevented than treated. Effective sunscreens are available in a wide variety of strengths. Most doctors recommend a sunscreen SPF level of 30 or greater.
Sunscreen should be generously applied. If out in the sun for a prolonged period of time during the day, wearing a hat and other protective clothing is recommended. Light clothing reflects the sun most effectively.

. Try taking a cool shower or bath or placing wet, cold wash rags on the burn.
. Avoid products that contain benzocaine, lidocaine, or petroleum (like Vaseline).
. If blisters are present, dry bandages may help prevent infection.
. If your skin is not blistering, moisturizing cream may be applied to relieve discomfort.
. Over the counter medications, like ibuprofen, may help to relieve pain from sunburn.

Call your doctor if you have a fever with the sunburn or if fluid-filled blisters, dizziness, or vision problems occur with it.

Source: /

. Stings - Stat: 1% of Irish people stung by wasps will have a severe allergic reaction.

Many insects sting as a defence mechanism, by injecting venom into the skin., Stinging insects include bees (honeybees and bumblebees), wasps, and hornets.
Most stings are painful but harmless, and only affect the area around the sting. However, some people can have an immediate and more widespread allergic reaction to being stung, such as an anaphylactic shock, which can be fatal. This is quite rare, affecting approximately 3 people in 100, and it normally only happens with a wasp sting.

When a person is stung for the first time, it is likely to be painful, and may cause some localised swelling. However, the first sting is not usually dangerous, but it can sometimes affect the immune system of people who are susceptible to allergic reactions. If the person is stung again, they may have an allergic reaction. This may be little more than swelling of the affected area, but sometimes the reaction can be the more serious anaphylactic type.

When you are stung by an insect, such as a wasp, the area around the sting will swell up, go red and a raised mark (weal) will form. It will often be quite painful and itchy. This will usually last for about 48 hours. If you have a localised allergic reaction to an insect sting a larger area around the sting will swell up and the swelling will last longer. However, it should go down within a few days.

Your symptoms will be more severe if you are stung many times by one or more insects. This is because of the amount of venom that will have been injected into your skin.

When should you seek medical attention?
Seek emergency medical treatment if, immediately after being stung, you experience any of the following symptoms:

. Swelling or itching anywhere else on your body
. Wheezing
. A headache
. Nausea
. A fast heart rate
. Dizziness or feeling faint
. Difficulty swallowing
. A swollen face or mouth

Call 999 for an ambulance immediately as you may be having a generalised allergic reaction and this can be fatal.

As soon as you realise you have been stung by an insect, you should remove the sting with your fingers or tweezers. If a child has been stung a responsible adult should remove the sting. When you remove the sting, be very careful not to spread the venom further under the skin. Bee stings have a venomous sac and you should try not to puncture this as you remove the sting. To treat insect stings you should:

. Wash the area with soap and water,
. Put a cold flannel on the area,
. Raise the part of the body that has been stung to prevent swelling,
. Use a spray, or cream, containing local anesthetic or antihistamine on the area to prevent itching and swelling,
. Take painkillers such as paracetamol (if the sting is very painful)
. Keep children's fingernails short and clean.

You should see your GP if the redness and itching does not clear up after 48 hours.
If you experience swelling or itching anywhere else on your body after being stung or if you have wheezing or difficulty swallowing, you should call 999 immediately for an ambulance.

You might be having an allergic reaction and may need to have an adrenaline injection, antihistamines, oxygen and/or an intravenous drip. Following treatment for an insect sting you may be referred to an allergy clinic or immunologist. Your GP may also suggest venom immunotherapy treatment. This involves being injected on a regular basis with small doses of venom so that you become desensitised and eventually cured of your allergy.