admin Uncategorized, Uncategorized, Vaccines

Why should we be vaccinating children against HPV?

Four out of five people will get HPV at some time in their lives and yet most of them do not even know they are infected!

We know that most (not all) HPV infections go away on their own, with no health complications that persist. However, we don’t know which of those infections will turn into cancer. Therefore, the best way to prevent HPV infection and the potential cancers it can cause is to get vaccinated. With the vaccine, we can reduce the risk of six different types of cancer:

  • Cervical, vaginal and vulvar cancer in women
  • Penile cancer in men
  • Throat cancers in men and women
  • Anus cancer in men and women
  • Genital warts in men and women
  • At what age should we get vaccinated?

It is recommended to administer the HPV vaccine before children are exposed to the virus, that is, before having sex. The vaccination age is usually at 11 or 12 years of age, but you can start getting vaccinated as soon as at 9 years old. It is ideal that the vaccination schedule be completed by reaching 13 years of age since at that young age the body develops more protection against HPV than in the last years of adolescence and the first years after having completed 20 years of age.

What is the HPV vaccination schedule?

If the first dose is given before the age of 15: only two separate injections / doses of 6 to 12 months will be needed

In contrast, children who receive the first injection of the vaccine series at age 15 or older, and those with weakened immune systems will need three injections of the HPV vaccine. The three injections will be administered according to the following schedule: the 2nd dose 2 months after the first and the 3rd dose between 6 and 12 months after the 1st dose.

What side effects may appear?

The most common side effects of the vaccine are mild, and are the same as those that may occur after the administration of other vaccines: fever, headache, as well as pain and redness in the arm where the injection was given.

Children and adolescents who are allergic to yeast or who are allergic to any other component of the vaccine that causes anaphylaxis should not receive the HPV vaccine.

Will my insurance cover the costs of vaccination?

Most medical insurance covers the cost of the HPV vaccine series but depends on each company, so it is best to contact your insurer directly.

Without financing, the public sale price of each dose of Gardasil 9 is 175 euros

 

Bérénice Ibarra Ottino

admin Respiratory health

Stop Smoking Program

Better Breathing for Life offers a unique evidenced based STOP SMOKING programme

“Smokers are 5 times more likely to quit for good with dedicated support compared to will power alone” 


We offer you a bespoke STOP SMOKING NOW programme in the Marbella area.  This unique programme utilises the beneficial effects of a natural herbal product made from the seeds of the “Golden Rain Tree” (Cytisus Laburnum).

This plant based product has been recognised as the closest substance to nicotine and is called Cytisine. In the brain it acts just like nicotine and stimulates the release of pleasure chemicals such as dopamine, which means that withdrawal symptoms from nicotine are greatly reduced. However, it has NONE of the side effects of smoking.

When combined with a stop smoking behaviour change programme, smokers who use Cytisine (taken as a small tablet), are more likely to stop smoking completely at 4 weeks than those who use patches (nicotine replacement therapy). Even after 6 months Cytisine is more effective than   patches and when compared to a dummy tablet or “will power” Cytisine doubles your chance of success.

For best results Cytisine should be taken as part of a stop smoking programme, incorporating education, action planning and behaviour change techniques.

Rachel Garrod Ph.D is a trained smoking cessation counsellor and respiratory specialist.

This comprehensive stop smoking programme consisting of;

  • Assessment of blood pressure and lung function measures.
  • Provision of herbal tablets (Cytisine) proven to reduce the urge to smoke and aid long term quitting
  • 3 specialised coaching sessions to help you stop smoking including hypnotherapy focused on facilitating sub-conscious activity to enable long term cessation of smoking

Comprehensive programme €350 per person

 

Please contact the clinic if interested.

admin Respiratory health

Quit smoking – with a little help from the Golden Rain Tree. 

Do you want to stop smoking? Like many of us you´ve probably tried numerous treatments such as patches, gum, acupuncture, hypnosis, etc – but – you´re still hooked. There are so many reasons not to smoke. Yet it´s one of the hardest addictions to give up.  And living here in Marbella doesn´t make it any easier!

But now there is another treatment that is generating interest among the scientific world. From the seeds of the “Golden Rain Tree” (Cytisus Laburnum) there is a product that has been in use for over fifty years in Eastern Europe and during the Second World War Russian soldiers even called it “false tobacco”.

In the West, until recently, this treatment was largely unknown as no proper testing or trials had been done. This plant based product has been recognised as the closest substance to nicotine and is called Cytisine. In the brain it acts just like nicotine and stimulates the release of pleasure chemicals such as dopamine, which means that withdrawal symptoms from nicotine are significantly reduced.

A large study, published in the highly respected medical journal, New England Journal of Medicine, has shown some exciting results. Cytisine (taken as a small tablet) in combination with what´s known as behavioural support was compared to nicotine replacement therapy, in this case patches. After a month more smokers had stopped completely on cytisine compared to patches (40 % versus 31%) and after 6 months and the cytisine group still showed clear benefit compared to patches. In other studies cytisine has been shown to double your chances of quitting compared with placebo (dummy tablet).

For best results cytisine should be taken as part of a behaviour change programme, incorporating education, peer support and behaviour change techniques. So if you want to stop smoking this year, why not take a helping hand from nature ?

Rachel Garrod PhD

admin Respiratory health

What´s happening with respiratory health in Spain?


As you may know I have a special interest in the physiotherapy management of Chronic Obstructive Pulmonary Disease (COPD). This long-term condition is generally caused by cigarette smoking but can also have genetic factors. COPD leads to impairment in lung function with patients suffering breathlessness on exertion, particularly when going upstairs or up slopes. They may have wheeze and cough and can also experience panic or anxiety associated with breathing. COPD is a very common disease and is one of the most frequent reasons for seeking medical attention. In the past decade or so there have been many advances in its treatment, not least the recognition of the role of the physiotherapist and the effectiveness of pulmonary rehabilitation. Pulmonary rehabilitation is an exercise and education programme -generally offered twice weekly for 8 weeks – designed for people with lung disease. There is plenty of evidence showing that pulmonary rehabilitation results in improved breathlessness, increased exercise tolerance and better quality of life. In the U.K you´ve got a good chance of being offered pulmonary rehabilitation as our guidelines specifically state that all patients with COPD troubled by breathlessness should be offered pulmonary rehabilitation.

But what about the situation here in Spain? A recent study published in the International Journal of COPD reports on a national audit of treatment of COPD in Spanish hospitals. Lopez-Campos and colleagues looked at 17,893 clinical records of COPD patients in outpatient respiratory clinics from 59 Spanish hospitals. They then compared the recorded notes with recommendations from the Spanish National Guideline for the treatment of COPD. The results show poor adherence to the guidelines in many therapeutic areas. Notably only 27% of patients had their inhaler techniquechecked; only 22% of smokers were offered a specific smoking cessation intervention; exercise performance (using a validated walking test) was reported in less than half the study population and only 41% of patients were even given advice regarding the importance of exercise. As to how many patients were offered pulmonary rehabilitation we simply don´t know!

On the other hand, the study showed that the Spanish hospitals recorded data on severity, diagnosis, frequency of chest infections and present medical treatments in most patients but many other aspects of recommended practice were not followed, or followed only in specialised centres.

Spain´s public health is to be commended for many outcomes, however there is a severe shortage of specialised nurses and physiotherapists, particularly those working in the community. It´s these gaps that need addressing in the management of COPD in Spain.

If you need physiotherapy help for your COPD please call or email

Dr Rachel Garrod

PhD MSc MCSP

Consultant Physiotherapist

rachelgarrod1@gmail.com

admin General health

Falls are not an inevitable consequence of ageing

The Chartered Society of Physiotherapy (CSP) is, this month, running a campaign highlighting the role of Physiotherapy in the prevention of falls. Falling in older age is a huge problem, falls are a major cause of disability and the leading cause of death in the over 75´s. Fortunately, most falls do not result in serious injury but in about 5% of those who do fall the person may need hospitalisation. It is estimated that one in three people aged 65 years and over experience a fall at least once a year – this rises dramatically to one in two among 80 year olds and older. Falls need to be considered seriously!

Falls may occur as a result of a multitude of reasons; balance problems, muscle weakness, poor gait, taking too many medications or medications that can make you dizzy, excessive alcohol intake, home hazards (stick the rug down that always slips- now!). Impairment in eyesight, incontinence (rushing to the toilet is an unfortunate common scenario); fear of falling (which can lead to altered movements) and cognitive impairments such as dementia.One of the strongest predictors of a fall is experience of previous falls i.e: If you´ve fallen once you´re likely to fall again. 

 

Whilst this is all very depressing it is good to know that Physiotherapy can help.  Exercise isthe most highly-researched fall prevention intervention and we now know that 8 – 12 weeks of a multi-component exercise intervention can reduce both the risk of falling and the rate of falls. To be effective programmes need to incorporate exercise that targets strength, balance, posture, gait, functional tasks, flexibility and endurance. Programmes that focus solely on strength training or walking have been less effective. But balance exercises can be performed quite simply at home, take a look at the CSP´s falls prevention video on YouTube https://www.youtube.com/watch?v=n8s-8KtfgFM – 6 simple exercises that have been proven to reduce risk. Falling is not an inevitable consequence of ageing. Please get in touch if you want further help to prevent falls.

 

Dr Rachel Garrod

PhD MSc MCSP

Consultant Physiotherapist

rachelgarrod1@gmail.com

admin General health

Being clever about the sun

It is already public knowledge that excessive exposure to the sun and its UV rays predisposes us to skin cancer (also known as Melanoma).

However, this does not mean that we should avoid sunlight altogether, since it also has many beneficial effects for our health: it helps to fight depression and it allows our body to synthesise vitamin D.

It is important to know and be aware that we must protect ourselves from the sun every day, and not only reserve the use of preventive measures for beach or mountain days. In effect, “even if you do not see it, the sun is always there” and the sun exposure accumulates day by day, year after year. It is that damage accumulated throughout our life that hurts us.

The simplest way to protect yourself from UV rays is to stay in the shade. But if you are going to spend time outdoors: follow these tips to enjoy the sun & being smart about it.

 

Protect your skin with umbrella and clothes and … Use sunglasses!

When you are outdoors, wear clothes that cover your skin. Clothing will provide different degrees of protection depending on the skin surface it covers (the more, the better!), Its color (dark colors protect more than light colors) and the type of fabric (thicker fabric offers better protection than fabrics with a looser weave). Also, dry clothes generally protect better than wet clothes.

Keep in mind that covering does not block all ultraviolet rays. If you can see the light through the fabric, ultraviolet rays can also penetrate it.

Many brands currently offer light and comfortable clothing, while protecting against UV exposure even when wet (the most typical are t-shirts to wear on the beach). These fabrics tend to be of a narrower fabric, and some have a special coating that helps absorb UV rays. This sunscreen clothing must have a label that indicates the value of the UV protection factor (UPF): the higher the UPF, the greater the protection against ultraviolet rays.

We will have to follow this same reasoning when choosing a hat: the ideal is to have a wing around it at least 5-8 cm to protect the ears and neck (areas where melanomas are often found), the face and the scalp. A dark non-reflective underside on the brim of the hat can also help reduce the amount of UV rays that reach the face and eyes and come from shiny surfaces, such as water. Some models even create a shadow (cloth of approximately 15 centimeters that hangs on the sides and behind the neck) at the level of the neck.

Lenses that block UV rays are important to protect the delicate part around the eyes, as well as the eyes themselves since it has been shown that spending long hours in the sun without protecting your eyes increases your chances of developing certain ophthalmological diseases.

Good sunglasses should block 99% to 100% of UVA and UVB rays. Look for an ANSI tag to make sure of it. The labels that indicate “UV absorption up to 400 nm” (absorption of ultraviolet rays up to 400 nm), or “Meets ANSI UV Requirements” means that the lenses block at least 99% of the UV rays. Those whose label indicates that they are of “cosmetic” use block around 70% of UV rays. If the label does not say so, do not assume that the lenses provide any UV protection.

You should know that the darker crystals are not necessarily better because the protection against UV rays comes from an invisible chemical that the lenses have or that is applied to them, and not from the color or darkness of them.

It is particularly important that children should also wear sunglasses with sunscreen and not toy glasses.

 

Choose the right time to get in the sun

That is: avoid exposure to UV rays when they are more intense, ie between 11:00 and 16:00. A good trick to know the intensity of the sun’s rays is the shade test: if the shadow is smaller than you, the sun’s rays are the most intense, and it is important that it is protected.

Take special care when you are on the beach or in areas where there is snow, since sand, water and snow reflect sunlight, and thus the amount of UV radiation you receive is greater. And remember that UV rays cross the surface of the water, the glass (of the car, of the houses, …) so that you can burn yourself even when you are in the water and feeling cool or inside a house when you are near a window .

Do not trust the windows of cars, offices and polarized glasses: they only block a part of the UV rays (UVA or UVB) and let the other part pass, which could therefore harm you.

 

 

Use sunscreen properly

It is important to know that sunscreen is only a filter that does not block all UV rays and should not be used as the first line of protection! In no way should be used to prolong your time of exposure to the sun thinking that the cream allows it! Consider sunscreen as part of your skin cancer protection plan, especially if you do not have shade and protective clothing as your first options.

For a correct selection of sunscreen, be sure to read the label. It is recommended to use products with broad spectrum protection (ie against UVA and UVB rays) and with a sun protection factor (SPF) with a value of 30 or higher.

It is also very important to apply a sufficient amount of sunscreen, without which it will not be properly protected. Think of it like this: put on cream, unless it works!

Sun creams can have sun protection factors (SPF) of up to 100 or more. The higher the number, the more protection it offers. However, there is no sunscreen that offers total protection.

Check the expiration date of the sunscreen to make sure it is still valid. Keep in mind that sunscreens that have been exposed to heat for long periods (trunk of the car during the summer …) could be less effective.

 

Make sure you apply sunscreen correctly

It is always recommended to apply a generous amount. When applying it, pay close attention to your face, ears, neck, arms, and any other area of ​​the body that is not covered by clothing. If you are going to use insect repellent or makeup, apply sunscreen first.

This application must be repeated at least every two hours to maintain protection. These creams can lose effectiveness when you sweat or rub yourself down with a towel. Therefore, they must reapply more frequently.

If you decide to use a sunscreen with a very high SPF, keep in mind that this does not mean you can stay in the sun longer, use less sunscreen or apply it less often: it only means that you will be better protected (which is great!)

 

 

Protect children from the sun

Children need special attention, because they usually spend more time in the open air, they can burn more easily, and they are not aware of the damage caused by sun exposure.

It should be avoided that babies under 12 months receive direct sunlight and should be protected from the sun with hats and protective clothing and glasses! Remember that exposure is cumulative throughout life: the sooner we start to protect ourselves, the more our skin will thank us!

 

In summary: we must …

1) Cover us with umbrellas, hat, sunglasses and appropriate clothing.

2) Avoid the sun between 11:00 and 16:00.

3) Use creams with at least SPF 30, apply it in generous amounts and repeat the application at least every 2 hours!

6) Extreme protection with children (hat, goggles, clothes, creams of FPS 50 or more).

7) Use protection in any outdoor activity.

8) Do not trust the cloudy days: the solar radiations can go through the clouds.

 

Bérénice Ibarra Ottino