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Your General Practice Questions Answered

Your General Practice Questions Answered

over 1 year ago by Jeremy Menz

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For July’s ‘Ask an Expert’ edition of #WellnessMatters, we interviewed Dr Yasmin Ameen, a General Practitioner from St Vincent’s Medical Centre, Australian Catholic University, and put to her all your questions regarding diets, skin health, sleep habits and more.

How often should I have a general check-up with my GP? What tests are run for a general check-up?

In terms of general check-ups, the frequency depends a bit on age. Generally speaking, once a year is enough for most people. As you get a bit older (over the age of 40), it’s worth going to get a check-up every six months.

Normally, a check-up will include the doctor asking lots of questions about what has been going on with the patient, and they will run physical tests such as checking blood pressure, listening to the heart and lungs, checking the abdomen, conducting a skin/mole check, and for females, a pap smear. In some cases, the GP may decide blood tests are necessary; however, they’re not needed for everyone – for young people in particular, it’s not usually necessary as we’re able to tell what’s been going on just by checking the patient physically in most cases.

How often should I be getting a skin/mole check?

It is recommended that you get your skin checked once a year if you have a family history of skin cancer. If there is no history, you can probably stretch this out to two years. If you’ve previously had a skin cancer yourself, you need to get checked more frequently (every six months or so).

What do/don’t I need a referral for in terms of seeing a specialist?

Pretty much all specialists who are qualified doctors require a referral. That being said, you can technically see them without a referral; however, you won’t be eligible for the Medicare rebate, so you will be paying a lot more out of pocket. Generally speaking, it always better to go and see a GP first because there are a lot of things we can sort out without you actually needing to see a specialist.

Other practitioners that you can see without obtaining a referral first include physiotherapists, dieticians, osteopaths and chiropractors, amongst others.

Another common one is psychologists – you can see them yourself; however, they may redirect you back to your GP because in some scenarios having a referral can be important. One, to make sure the doctor doesn’t need to organise any tests for you, and two, it can help you with claiming the aforementioned Medicare rebate.

How long will a steroid injection mitigate my pain for?

Some people respond really well to steroid injections and they may get pain relief for up to a year (in some cases, even more). Conversely, some people don’t respond as well and may only get pain relief for a few months, and some don’t really respond to them at all. In most cases, you’ll be able to tell within a week if it’s worked or not.

During a sunny/high UV day, what is the best sort of clothing to wear?

Ideally, particularly during the times of high UV rays during the day (10am – 2pm), you generally want to be wearing long sleeves, long pants and a hat to protect as much of your skin as possible. You should also wear SPF 50+ sunscreen to protect yourself. In terms of clothing, there are also SPF ratings and it’s worth having a look at that.

Is breast cancer sometimes hereditary, or is it solely developed in an individual patient?

The majority of breast cancer cases are not hereditary, but there are a couple of sub-types of breast cancer which tend to run in families. Generally speaking, if you’ve had more than a couple of people in your family who’ve had breast cancer, it’s worth having a chat to your doctor to see whether it could be a hereditary type or not.

What are some things to be mindful of when commencing a radical or “fad” diet?

The main thing to be mindful of is that most fad diets are really not that effective.  If you are trying to lose weight, you’re better off seeing your GP and coming up with a healthy meal plan that will help you lose weight in a sustainable way.

A lot of fad diets will be quite extreme and subsequently difficult to sustain, so a lot of people tend to just get sick of them after a period of time and give up. Additionally, these diets can also lack really important nutrients due to their restrictive nature, putting the participant at risk of developing vitamin deficiencies. It’s worth having a chat to your GP or dietician before commencing any new diet to make sure the one that you’re considering is suited to your body and your body’s requirements.

Intermittent fasting diets are becoming increasingly popular at the moment; however, at this stage there is no real evidence base associated with these, so it’s best to steer clear due to the stress they can put on your body.

What are some non-medicinal ways to treat/mitigate the symptoms of migraines?

The most important thing is identifying the triggers and subsequently avoiding these. For a lot of people, migraine triggers will include being overtired and consuming too much coffee and/or chocolate, so if they’re causing your headaches/migraines, you need to avoid these.

Another common cause is neck tension, so it’s important to ensure your work desk/station is set up well so that you’re not having to strain at all. It’s also important to use a good pillow when you’re sleeping. Neck stretches and physiotherapy are the next step in the management of tension.

Additionally, mental stress can also cause migraines to develop, so make sure that you’re eating well, exercising and taking care of your mental health.

My teenager, like many others, loves taking a nap. What is the best amount of time for a teen to sleep in the afternoon if they’re to recharge and resume their day afterwards?

A powernap should definitely be less than 20 minutes in length. When you start to nap for longer than that, you’ll often wake up lethargic and it can impact your quality of sleep at night. Ideally, you’re not having any naps throughout the day because you’re getting adequate sleep at night time. Don’t stay up as late so that you can get a good night’s sleep – this will mitigate your need for napping.

If you are really struggling and are in need of a nap, it should be less than 20 minutes in length and ideally it will be earlier in the day to avoid impacting your sleep. Granted, teenagers require more sleep than adults, so make sure they’re adhering to the above guidelines if they are napping.

I rely on coffee to keep me alert during the day. What are some healthier foods/beverages I can consume in place of coffee that have a similar effect on my alertness?

There’s no real substitute drink for coffee that contains a comparable amount of caffeine other than tea. There’s Coke, but I would never recommend consuming this due to the amount of sugar that it contains. My general advice would be to ensure you’re getting enough rest, eating a balanced diet inclusive of two fruits and five vegetables per day, keeping your protein intake up, and drinking two litres of water daily.

Further to the above, what are some sleeping habits that you recommend?

There are a whole range of practices that fall under ‘sleep hygiene’. These include (but are not limited to):

  • No screen time (TV, mobile phone) in the hour (ideally two) before bed as these affect your body clock;

  • Doing something relaxing before bed such as reading a book;

  • Having a warm bath or shower;

  • Ensuring your room is cool and dark (and quiet if possible, though this can be hard if you live on a main street!);

  • Avoiding naps throughout the day; and

  • Minimising coffee consumption, particularly late in the day, as this can impact the quality of your sleep.

Are there any over-the-counter sleeping remedies that can be used in place of prescription medication, should the need arise?

There are a few options if you’re still struggling to sleep after implementing the above. The main one is melatonin – melatonin is the chemical in your brain that helps regulate your body clock. There are a few herbal supplements which contain melatonin that may be of use.

Generally, a prescription medication will be more effective as you can’t guarantee the dose of melatonin in a herbal supplement. The other commonly used medication is Restavit, which is actually an antihistamine tablet that can make you drowsy, so this can be used in the short term (say if you’re having a bad night and you desperately need sleep). If this is the case, however, your best course of action is to attend your GP.

Do you have a health profession you would like us to explore? If so, please email jeremym@beddison.com.au and we’ll do our best to cover this field in future editions of Ask an Expert.

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