Davenport House Surgery, Harpenden
Bowers Way
Harpenden
Hertfordshire
AL5 4HX

Chronic Diseases

Asthma Care

The practice aims to review all patients who need regular use of medication or who suffer from severe or troublesome Asthma every year.

Who should this include?

  • Any patient who has received regular medication for Asthma within the preceding 12 months 
  • Asthmatics who have received care during an emergency admission to hospital 
  • Asthmatics who have difficulty in controlling or monitoring their condition

The Asthma Nurse will aim to monitor your Asthma using the following criteria:

  • Assessing Asthma control from residual symptoms and limitations including the effect of asthma on work or school absence
  • Assessing control by measuring Peak Flow readings and comparing with expected readings after adjustments for age and height
  • Assessing inhaler technique with the aim of maximising effectiveness of use by tailoring the type of inhaler or method of inhalation to suit the individual
  • Monitoring for potential side-effects as a result of treatment
  • Provide a personal Asthma Management plan to help Asthmatics respond to changes in symptoms and Asthma readings.

What are the aims of treating Asthma?

  • Your doctor will want you to stop smoking- either if you are an Asthmatic yourself or you live with someone who has Asthma.
  • The aim is that symptoms of Asthma should be reduced or abolished completely to allow you to live a normal active life. This may require you to use inhaled and/or oral therapy on an intermittent or continuous basis.
  • Give sufferers or their carers an understanding of the causes and triggers of Asthma and knowledge of effective preventative measures to reduce these in the future.
  • To teach sufferers or their carers how to recognise and react to changes in symptoms of Asthma and to develop a plan of personal care.
  • To tailor therapy to maximise effectiveness and safety from possible side-effects.
  • Treatment for asthma is normally given along the nationally agreed guidelines by the British Thoracic (Chest) Society that advises doctors and patients to tailor their therapy according to severity.

Diabetes

The practice aims to review all patients who have Diabetes at least yearly. Some patients may need to be seen more frequently with guidance from your doctor or nurse.

There are many types of diabetes and management depends on this as well as other factors such as age, presence of complications and other medical conditions.

What are the aims of treating Diabetes?

  • Your doctor will want you to stop smoking and loose weight to within the normal range for your height. 
  • Weight loss is more likely if you adopt a combined approach of calorie restriction and dietary change with a progressive and steady increase in exercise 
  • Your blood sugars should be monitored frequently - especially when unwell 
  • Blood sugar levels should always be in 'single' figures and for certain Diabetics all levels should be less than 8 mmol per litre 
  • Good long term control of Diabetes is indicated by a Glycosolated Haemoglobin of less than 7%. 
  • The ideal Blood pressure should be controlled below 130/80 - if necessary by drug therapy if natural measures do not succeed. 
  • Cholesterol levels should be below 5.0 mmol per litre with the portion of harmful cholesterol called LDL (Low density Lipoprotein) below 3.5 mmol per litre. 
  • Measurement of kidney function using both blood and urine tests should be undertaken yearly 
  • Some patients should take Aspirin 75mg per day with meals 
  • Examination of eyes, feet, and nervous system should also take place yearly

Each year diabetics will receive an invitation to have their eyes checked by a special camera that examines the back of the eye to detect early changes that may cause problems with vision.

Patients are able to have access to a chiropodist and dietician if needed.

They are also encouraged to learn self monitoring of their diabetes as well as general education about their condition.

Heart Disease Care

The practice aims to review all patients with a history of heart disease every year.

What are the aims of treating Coronary Heart Disease?

  • Your doctor will want you to stop smoking and loose weight to within the normal range for your height. Weight loss is more likely if you adopt a combined approach of calorie restriction and dietary change with a progressive and steady increase in exercise. 
  • Cut down stress - especially regular feelings of aggression or anger. This stimulates the body's 'fight and flight' system and leads to higher levels of cholesterol and stress from adrenaline on the heart directly. Learn ways to relax and reduce confrontation in life. 
  • Your Blood pressure should always be controlled below 140/85 - if necessary by drug therapy if natural measures do not succeed. 
  • Cholesterol levels should be below 5.0 mmol per litre with the portion of harmful cholesterol called LDL (Low density Lipoprotein) below 3.5 mmol per litre. There even more recent research that patients who have had a heart bypass or Angioplasty need to lower their cholesterol even further to less than 4.8mmol per litre. Most patients will require a drug to achieve this - which is safe and usually without side effects. 
  • All patients should take Aspirin 75mg a day with meals - unless they are allergic to it or have a recent history of stomach ulcer causing bleeding. 
  • Patients with Angina should also be taking a drug called a Beta-blocker. 
  • In addition some patients will be advised to take a medicine called an ACE Inhibitor which relaxes all arteries and allows the heart pump more easily. Common names are Captopril or Enalopril. 
  • Women should consider HRT for at least five years - unless there are other reasons not to.

Hypertension Care

The practice aims to review all patients who need medication for Hypertension at least yearly. Some patients may need to be seen more frequently with guidance from your doctor or nurse.

What are the aims of treating Hypertension?

  • Your doctor will want you to stop smoking and loose weight to within the normal range for your height. Weight loss is more likely if you adopt a combined approach of calorie restriction and dietary change with a progressive and steady increase in exercise. 
  • Your Blood pressure should be controlled ideally below 140/90 - though a level of below 160/100 maybe satisfactory. 
  • Cholesterol, Glucose and kidney function tests should be measured yearly 
  • Some patients will be advised to take Aspirin 75mg a day with meals once their blood pressure is well controlled.

The practice has its own fully computerised electronic 24 hour blood pressure monitor that can be used to assess blood pressure control. This is attached as a small device to the person- who able to wear this comfortably during normal daily activities and sleep.

Mental Health

Depression affects 1 in 3 of us during a lifetime. There are many reasons including our personality and inherited predisposition. Most often it occurs when we are going though periods of stress especially loss or threats to our lifestyle and future. If you've been feeling "down" for more than a few weeks or are having difficulty functioning in daily life, you may be experiencing more than just the "blues." You may be suffering from clinical depression.

Clinical depression is highly treatable but most people do not seek help when they should - often because they don't know the symptoms, or think their depressive feelings will go away on their own. Sometimes they are embarrassed to talk about how they're feeling. Depression has a biological component - it is not about being a 'wimp' or having to 'pull your socks up'. Modern antidepressants are safe and non-addictive. They work by re-balancing the levels of certain brain chemicals involved in setting mood.

Symptoms may include:

  • Low mood, especially in the morning. 
  • Tearfulness often without apparent reason. 
  • Poor concentration. 
  • Disturbed sleep, especially waking early unable to return to sleep 
  • Change in sex drive.
  • Poor self image. 
  • Loss of confidence. 
  • Irritability that is out of character. 
  • Alcohol and drug abuse that is unusual. 
  • Inability to enjoy usual pleasures like good music, art or games. 
  • Feeling suicidal and planning how to end your life. 
  • Tiredness all the time, severe lack of energy or stamina.

Answer 0 - 4 on the scale to each of the following questions - and add them up to help you decide if you should seek help from your doctor.

0 - None or little of the time
1 - Some of the time
2 - Most of the time
3 - All of the time

Over the past two weeks:-

  • How often have you been feeling low in energy or slowed down? 
  • How often have you been blaming yourself for things? 
  • How often have you had poor appetite? 
  • How often have you had difficulty falling asleep or staying asleep? 
  • How often have you been feeling hopeless about the future? 
  • How often have you been feeling blue? 
  • How often have you been feeling no interest in things? 
  • How often have you had feelings of worthlessness?

A Total score of 8 or more may indicate you are suffering from depression and you should see your doctor to assess things further.