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Wed, 25th November 2015

Some people are tired. Not just a bit tired, but tired and tired all the time. What's more, most have wandered from doctor to doctor, undergone innumerable blood and other tests, all of which come back normal. If left, it may gradually get worse. Some end up in wheel chairs. Its common name is CFS - Chronic Fatigue Syndrome. No vitamins, Pills, placebo (fake) tablets or anything else seem to help.

A while ago, some doctors in Perth's University of Western Australia dreamed up a simple solution. What's more, they found it worked with many patients, even long term ones who'd been bugged for years They called it "The Exercise Prescription". "Engaging the patient", that means getting them on side and gaining their confidence was essential. Then the programme starts. Many patients fear exercise will exacerbate their symptoms but this treatment says the opposite.

Get exercise, your symptoms will often gradually lessen and may finally vanish. Exercise is started every second day, and in a form that uses all major muscle groups. They suggest walking, swimming, cycling or even jogging. For the first fortnight, time gradually increases from one to ten minutes, depending on the persons capacity. If they feel unwell one day, maybe miss one but then recommence. If already on some exercise routine, this method is on top of this, and also on top of any regular duties they are carrying out.

Patients are taught how to take their pulse and record. A diary is kept on how they feel, called the "Perceived Exertion Scale". It is carried out under medical supervision. Patients are told exercise also helps improve physical function, cardiac failure, mood swings and depression and other psychological conditions. It costs nothing and is worth a try. CFS is common in the community.



Doctors seem to be prescribing paracetamol more and more, especially for arthritis. Which brand is best?


Paracetamol is the generic name for what is currently the world's most widely used pain killer. All brands are the same. Some have codeine added, then the brand name will end with "-eine". This causes constipation in many patients. Usual tablet has 500 mg but a more recent one contains 650 mg in a slow release formula which can last up to 8 hours and requires less per day. As there has been so much trouble and negative publicity swirling around the NSAIDS and COX-2 inhibitors, they are currently out of favour. Some doctors still prescribe them but in much reduced doses.

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I have endured persistent bloating, and general abdominal discomfort for ages. Endoscopy and colonoscopy showed no abnormality, so the doctor has suggested I swallow a camera!


Yes, this miniature camera gradually winds its way through the entire bowel system. It sends out signals which are recorded. Certain diseases can be picked up this way, and correct management started. Do not be alarmed. The camera will resurface. It is a different way of becoming a movie star, but may be effective. It will not make the front pages of the newspapers. (Gasp! Gasp!)

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We occasionally hear of children being stung by a bee and suddenly dying.


This is true. It is a sudden allergic or "anaphylactic reaction" to the bee venom. It is pretty rare, and more likely on a subsequent bite. For this reason, some youngsters carry an "Epi-Pen". This is a syringe and needle preloaded with a measured amount of adrenaline that can rapidly abort adverse reactions. It may be life saving. Kids can be taught to self administer. They should also avoid going barefoot on flowering lawns where bees abound.

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My parents refuse to have a smoke detector installed.


Legislation in many States now makes it mandatory for all dwellings to have a smoke detector. It is possible to use long term batteries claimed to last up to 10 years. If they refuse, do it for them - it is pretty easy and cheap. Older people cannot be bothered with the exertion and cost. Also it is not wise for them to be climbing up ladders and chairs to do the job.

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I had a severe fracture of my leg, the bones refused to heal, and a metal bar was inserted. I also have to wear a metal prosthesis to walk. The pain gets very severe, especially at night. The usual pain killers do not last long.


Referral to a pain clinic is suggested. Here the cause of the pain will be re-evaluated. Suitable management strategy will be worked out. Today, a single long term skin patch may last up to one week, and can provide excellent relief from pain. Talk again with your doctor.

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This health advice is general in nature. You are advised to seek medical attention from your doctor or health care provider for your own specific symptoms and circumstances.



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