Community: The Social

Health chat with Gemma Newman

Friend of TheSite.org, Dr Gemma Newman, popped in to live chat to answer your questions on the contraceptive pill, low moods and the swine flu jab.

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flower123: I'm not too good at the moment. I went to my GP appointment this morning and hated it. I have problems with hypothyroidism. I have had my dose increased twice now and I am wondering how long it takes for an increased dose to work? I have abused these tablets in the past due to their weight loss side effect due to my bulimia. Would this affect my thyroid function?

Dr Gemma Newman: Hi Flower, sorry to hear your appointment didn't go too well. If you don't mind me asking, how old are you and how long have you had hypothyroidism?

flower123: I'm 20 in December and I've had it since April. I hate having borderline personality disorder so much. I just felt as if the GP had read stuff and that was it. I also got grilled about my overdose.

Dr Gemma Newman: The first thing to mention here is that obviously it sounds like you've got quite a lot going on as well as the hypothyroidism.  Your recent overdose is an important health issue and worth discussing in its own right.  With regard to the thyroid tablet dose - as a rule of thumb, ideally you would check the body's response to thyroxine at a minimum of four weeks. This is due to the half-life of the medicine; any change in dosage will take that long to come up in your system.  Unfortunately, if the tablets are taken inconsistently the body's response would be confusing as it would be harder to control the condition.

flower123: OK thanks. I just feel so tired. Getting up and walking and stuff is difficult. I have got ALOT going on - OCD, anxiety, self harm, bulimia and bipolar disorder, but self-harm is the worst at the moment. I watched your film, it was very helpful :)

Dr Gemma Newman: Thanks, I'm so glad it helped you.  It's important to be able to discuss the issues of bipolar disorder and bulimia as well as self harm with an empathetic doctor. If you've not had a good experience perhaps you should consider seeing a different GP?

flower123: I saw her because she was female and I thought that would help. I couldn't get an appointment with my normal GP which was a pain.

Dr Gemma Newman: There are a lot of different reasons why you might be finding it hard to get up and feeling tired and it would be worth getting an assessment to rule out any other causes. Good luck with getting the help you need and again I'm really glad the video helped :) There are also some great resources mentioned in other places on the site which may useful.

**helen**: Thanks Gemma. We've had a few questions come through from people who couldn't be here tonight so we'll move on to one of those.

Broken-Angel:  How can the pill help with hormone problems? I am wondering because I have been told that the pill can help settle down hormones but I don't really get it.

Dr Gemma Newman: Hi, thanks for your question. People take the combined hormonal contraceptive for prevention of pregnancy and there are some other advantages too. These include lighter periods, reduced fibrocystic breast disease and reduced risk of ovarian cancer among other things.

However, there are also associated side effects and these would include increased risk of blood clots in the legs and the lungs and a slightly increased risk of breast cancer as well as other reported hormonal side effects like acne, bloating and appetite changes.

There are many different types of combined pill and the right type for individual patients will depend on different circumstances. There's no hard and fast rule as to how it would affect your moods as it can be very different for different patients.

It's not given as a treatment for depression or emotional upset for example. In fact another recognised side effect in some people can be depression or reduced libido!  The best thing to do would be to talk to your doctor if you're worried about hormonal problems you've been having and see how they can help you.  If you're interested in it as a form of contraception, you can discuss whether it would be right for you with your GP; but there are other alternatives you may not have heard of such as the patch, the injection or the implant.  (For more information on contraceptive choices you can check out the family planning association website.)

MoK:  I have a three year old and I see that the swine flu jab is going to be offered to all under fives. So I have a couple of related questions. Do you think that the risks of vaccination are outweighed by the risks of catching H1N1?  I understand that GPs have been offered the vaccination, did you have yours? I'm also hearing that some people have had side effects - unable to raise arm, feeling under the weather etc., what's your experience from your practice?   And finally, do you think that the NHS has actually coped very well with the outbreak, given the state of emergency in places in the US and the fact that their outbreak seems to be following a typical pandemic rate whereas the UK seems to have steady rates? Or is this just luck?

Dr Gemma Newman: Thanks for your questions. There's been a lot of understandable anxiety about vaccinating children especially when there are side effects as a result of having the immunisation. As you mentioned in your question, side effects would include arm ache, local irritation and redness and the possibility of mild fever in the 48hrs following the injection.

However, studies have shown that children are at a higher risk of complications from having been exposed to swine flu and this is the reason why the benefits of the immunisation do seem to outweigh the possible side effects.

I myself have had the vaccination and have suffered no ill effects personally. I know that myself and my colleagues have worked very hard to make sure that guidance received from the government as to treatment and prevention of swine flu has reached grass roots level and it's hard to say what the patterns of infection will be in the coming months. Hopefully we can do our best to answer patient's concerns with the information that we have been given. I hope that answers your question.

Annaarrr!!: I feel empty and numb quite a lot and I don't know why,  any advice?

"Myself and my colleagues have worked very hard to make sure that guidance received from the government as to treatment and prevention of swine flu has reached grass roots level."

Dr Gemma Newman: Sorry to hear that. Feelings of emptiness and numbness can often be related to low mood, is there anything that you can think of that might be making you feel low at the moment?

Annaarrr!!: Not really.

Dr Gemma Newman: If you don't mind can I ask how old you are, what are you up to at the moment too - studying or working maybe? And also, how long have you been feeling this way?

Annaarrr!!: I'm 13 and I'm just sitting down on here. I'm really tired. I don't know, a year I guess but it's on and off.

Dr Gemma Newman: Thanks for telling me that, have you spoken to anyone about how you're feeling? A close friend or someone you can confide in?

Annaarrr!!: No I haven't.

Dr Gemma Newman: Talking things through can really help and you can always talk to your GP if you don't feel like talking to someone in your family for example. Your GP will be able to have a confidential chat with you about your situation.

Annaarrr!!: Yes, but they might contact my parents.

Dr Gemma Newman:  Other things you can try at home would be to write some things down, any reasons why you might be feeling low, just to gather your thoughts.

Annaarrr!!: OK I'll try that, thank you!

Dr. Gemma Newman:  In answer to your concern regarding your doctor telling your parents - even though you're only 13, if you go to see your GP in confidence, unless you are a danger to yourself or somebody else, they will always respect your confidentiality. 

Annaarrr!!: They may not respect it then.

Dr Gemma Newman: I'm sorry to hear that you're so low. If you're worried about going to your GP then finding someone else to talk to would be a good idea. You might want to try calling a helpline such as ChildLine or the Samaritans if you don't feel like you can reach out to someone close to you.

**helen**: Samaritans is 08457 909090 or email jo@samaritans.org and Childline is 0800 1111 and they have lots of online support too.

Annaarrr!!: Ok thank you, I'll keep those in mind.

Dr Gemma Newman: If you do feel desperate, they are friendly, trained advisers who will listen and talk with you.  Generally speaking, there are lots of ways that you can help yourself to feel better too. This would include a healthy diet and physical exercise, which has been proven to improve mood. It's also important to try and spend time with friends and do things that you enjoy as well as trying to keep a good sleep pattern.

I would urge you to talk to someone you can trust about how you feel and I hope you start to feel better soon, my thoughts are with you.

AThiefAWhoreAndALiar: My question is, I've had this weird tightness in my jaw all day, and I was just wondering what this could be? It's been pretty annoying, lol.

Dr Gemma Newman: Thank you for your question, there are a number of possible causes which could include general muscle tension, a dental problem or dental infection, or some kind of joint tenderness at the top of the jaw.

 

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