Past posts

'Tis the season to be vaccinated

By Dr Karen Robinson

Dr Karen Robinson

Saturday morning dance class… (not mine of course, my daughter’s). I’m safely nestled in the nice warm coffee shop next door, sipping on a latte. Thing is, I’m surrounded by sniffles, coughs and runny noses and there’s not nearly as many tissues being used as I’d like.  “Please don’t splutter over me”, I cringe silently… Argh! I’ve chosen virus central to have a coffee!

I remember my mum saying “You will catch cold. You will get the flu.”

Well I might catch their coughs and colds, but it is unlikely that I will get the flu. You see, I had my flu jab the day they arrived at the surgery.

Also, young children get a nasal spray flu vaccine at school. It’s actually more like nose drops. All those in year R to Year 4 get it. So, in a roundabout way, that nasal flu vaccine also helps protect me, their brothers and sisters and also the grownups because if the younger ones don’t get the flu, they can’t give it to other people. A ‘herd immunity’; you may already know about it.

All children aged two or above on August 31st, 2017 (but not yet in school) and children who have long-term health conditions (for example, asthma, diabetes) who are in Year 5 or above, will have been called in to be given the nasal spray vaccine at the surgery.

As I take another sip, I look around and hope that the chap sitting at the table next to me slurping his coffee has had the flu jab. He keeps clearing his throat. I think he may be coming down with something.

A lady joins him. “I need a break. My dad is down with the flu. He is in bed with a fever, sweating buckets. He keeps coughing and complaining he’s aching all over. I have never seen him so ill.”

“I kept telling him to come with me to the GP to get his jab, but you know what he’s like – ‘I’ve never had the flu so why should I bother with it now?’  It’s a good job I’ve had mine. The last time I had the flu I ended up in hospital with pneumonia ‘cos my immune system couldn’t fight it off so easily because of my diabetes!”.

(Top tip: The flu vaccine is offered free of charge on the NHS to people who are in an ‘at risk’ group because they can get a serious complication like pneumonia and even die.

I recognise the lady. She is a patient at my surgery. “Hello Doctor” she says. (Oh no, I thought, I’m not at work now! My cover’s blown!). “I read on Facebook that the flu vaccine can give you the flu. Is that true?”

Cue another episode of ‘Medical MythBusters’! The short answer is ‘no’, the vaccine can’t give you the flu. The flu jab contains inactive flu viruses and the nasal spray flu vaccine contains live but weakened flu viruses. You might get a bit of a temperature as your body produces the antibodies to attack the viruses, but you can’t get the flu.

“Why do I need to have a flu jab every year?” she asks.

Flu viruses doing the rounds each year can be different strains so a new vaccine is produced each autumn/winter to protect against the flu viruses the experts predict to be the most likely culprits for that year. As flu can be caused by different flu viruses, the antibodies you get after actually having the flu will only protect you against that particular strain. The vaccine will protect you against the other predicted circulating strains too.

“Can dad have some antibiotics?” For the flu, the answer is no because flu is caused by viruses and antibiotics only work against bacteria. If you do get a bacterial chest infection (like pneumonia) as a complication of viral flu, you may need antibiotics to treat that. 

Her dad does sound like he is quite ill, so I advise her to call 111 to speak to the out of hours GP, who will call her back and then see him. She does not need to take him to A&E but she shouldn’t leave it until Monday because may potentially have a complication from the flu, like pneumonia. A doctor would need to see him to advise on treatment.

“You look after your dad. Don’t you?” she says to the chap. “Hope you’ve had your jab!”

She is right. As his dad’s carer, he should have the flu jab because if he gets the flu he will be more likely to give it to his dad. Also if he gets ill someone else would have to look after his dad whilst he  recovered.

Just as round two of Medical Mythbusters appears to be about to start my phone rings. “Can you collect your daughter? Her class has now finished.”

Is that the time already? Back to being mum!

Breathing easier over the winter

Second in the queue at the petrol station in the freezing cold, wishing I had ‘paid at the pump’. The lady in front of me: “Pump 7 and 20 Rothmans please” to the chap at the counter.

I recognise the lady. “Hello doctor. You ok? You will be pleased with me. I had my flu jab and I’ve got my rescue pack.”

Rescue pack? I’m re-playing the RAC guy on the telly earlier: “Pack an ice-scraper, de-icer, warm clothes/blankets and take any medication you need for the next few days with you in case you break down”.

Then the penny drops. She is talking about her COPD rescue pack. That is so important if you have COPD, as the chest infections that cause flare-ups always seem to happen on Friday evening or when going to visit friends over Christmas. You are just not supposed to get ill at those times. It is so inconvenient when you have a party to go to!

COPD is Chronic Obstructive Pulmonary Disease. It’s a term for lung conditions including chronic bronchitis and emphysema.

“You diagnosed my COPD last winter,”she says. “I had that cough which just would not go away. I kept coughing up phlegm and sometimes had that horrible wheeze. I just could not breathe properly”. You got me to do a breathing test and have a chest x-ray.”

The breathing test is called spirometry reversibility testing. She had to blow into a special machine that drew a graph of how much air she could breathe out of her lungs and how fast she could breathe it out.

“I know you said that the single greatest thing I could do is quit smoking. I have really tried but it is so hard. I know your nurse can help but I can’t get to appointments or to those Quit4Life sessions. My brother says you can do this telephone support thing. Can I call them myself?”

Yes. It is a self-referral service. Quit4Life provides a telephone support service with free one-to-one support, right from helping you to prepare to quit through to until you have been smoke-free for at least 4 weeks. The weekly support and the Quit Pack of stop smoking products is provided on the NHS. Quit4Life can support you to stop smoking in many other ways as well including online support and face-to-face sessions with an adviser. Have a look at their ‘Top quit Tips’ blog as well as their website. Quit51 provides the Stop smoking service in Farnham/Surrey.

Back to that rescue pack. For this lady, it is a pack of antibiotics and steroid tablets she keeps with her so she can start taking them straight away if she gets a chest infection or if her breathing gets worse. She can start the pack before she sees a pharmacist, nurse or a doctor. She will also need to increase using her inhalers in the way I explained to her in the surgery.

“I did go to the pulmonary rehabilitation course you referred me to. They were spot on. Helped me with an exercise plan and taught me different ways of breathing. They did help me stop smoking as well but I think I need the extra phone help from Quit4Life. I will give them a call to try again.”

There you have it. The RAC got the rescue pack bit right for her: “Take warm clothes and take any medication you need for the next few days with you”. And “Pack an ice scraper and de-icer for me!”

Useful links with information on smoking cessation services and tips that you can use yourself:

For Hampshire residents:

For Surrey residents:

And for everyone:

Self Care is for life

By Dr Karen Robinson

So, I’m up to my 48th prescription of the day and I suddenly think, there are fewer days until Christmas than the number of prescriptions I have signed! My mobile rings. Too busy to answer but it’s a voicemail from my friend - “Just calling to find out what your kids might want for Christmas”.

 Christmas! I haven’t quite got that far yet. Always thinking of others… family, friends… patients. It’s also Self Care Week (November 13-19) - Embracing Self Care for Life. Looking after me? The irony!

Self care? When do I have time to look after myself? Busy job and like many mums, unpaid taxi driver for the kids, groceries, Christmas shopping…..The list goes on!

But really – thinking about it, looking after yourself doesn’t necessarily take that much. Do I need to use the lift when there’s a perfectly good set of stairs next to it? Just finished a lovely cup of tea, but did I really need that biscuit? Maybe I could do without that glass of wine later.

As amazing as it sounds, it is the simple everyday things that count towards self care.

Self care can be the little things or it can be the big things. Self care is for the important people in your life and self care is for yourself! You might want to run a marathon but for me, Couch to 5K is about as much as I can muster. For some it’s a short walk. Just something, rather than nothing. It’s those small steps… insignificant, maybe, to some. But great leaps for others.

Self care includes keeping fit, having a well-stocked medicine cabinet at home, knowing that your pharmacist can help with treating minor ailments and how to take prescribed medicines to their best effect. If you have a long term condition, self care is about understanding and managing the long term condition, giving you the best opportunity to make the most of your life.

Back to those prescriptions. I don’t want my patients running out of their medication over Christmas!

Then the drive home, listening to ‘MAGIC’ and later having a chat to my friend will help me unwind and de-stress.

Self care is for life. Today, I’m good to go! If you have friends who could do with a self care pick me up, share my blog with them. Follow my blog on


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