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Every week, the Pharmacy Self Care Program (from the Pharmaceutical Society of Australia) publishes a Health Care Facts column.  This also appears in the Herbert River Express every week.

For your convenience, they will be published here - feel free to browse back over past editions.


John Bell Column 18 Jul 2012

Pharmacy Self Care Health Facts Column
By John Bell –18 Jul 2012


Managing persistent pain


We all suffer pain from time to time. Pain is an important signal that our body has been damaged in some way; and so attention is required to treat or remedy that damage.

Pain can be acute, meaning that it comes on suddenly and lasts for a limited time, or it can be chronic, that is persistent and long lasting. Acute pain may only last a few minutes, but may be hours, days or weeks; and it could be caused, amongst many other things, by insect bites, burns or broken bones.

At best this pain is unpleasant, however when it becomes not only severe, but also chronic, it can all but destroy our quality of life. Coping mechanisms for chronic pain often involve the use of pain relievers; and various pain relievers are available which work in quite different ways from those pain relievers we would normally expect to use for acute pain. Some non medication treatments might also be helpful.

This year, the patient support group, Chronic Pain Australia, has again organised National Pain Week (22 – 28 July) to raise awareness of both the problems of chronic pain and some of the effective management strategies.

The Chronic Pain Australia website ( states that one in three Australians live, directly or indirectly, with chronic pain. And almost two thirds of these people suffering with chronic pain say it interferes with their daily activities.

The leading cause of chronic pain is reported to be related to injury – possibly sports injuries or car, work or home accidents. But sometimes the cause is not so easy to identify.

Modern medicines work in several ways.  They can prevent disease, cure disease or palliate (i.e., reduce the severity of) the symptoms.

The need for pain relief as a part of palliative care would seem quite obvious, but for many reasons pain relief is neglected or not provided in an effective way.

In the past 10 years or so more attention has been focussed on the benefits of the so-called opioid type pain relievers such as morphine (morphine was first isolated in the early 1800s, although evidence exists that the raw material opium was in use several thousand years ago).

Most doctors and pharmacists have a very good understanding of the benefits of the opioid pain relievers such as morphine.  However, there are still misconceptions in the minds of many patients, their families and carers. The fact is, when used appropriately, they are both safe and effective.

Recently we have seen the development of a number of variations on the old morphine mixtures – preparations which are easier to take, more palatable and less likely to cause uncomfortable side effects.  There are long-acting and sustained release tablets and capsules, as well as patches and lozenges in doses which can be individually tailor-made.

Of course, opioid analgesics aren’t the only option – and not even the best choice on many occasions.  Simple pain relievers like paracetamol or the non-steroidal anti-inflammatory medicines can be very effective when taken in the right dose.  And medicines such as antidepressants, anti-epileptics, antispasmodics and steroids – medicines not normally associated with pain relief by patients and their families – are often the most appropriate choice.

There might also be the need for regular laxatives or occasional anti-nauseants and possibly something for dry mouth caused by the side effects of some of the medicines.

The World Health Organization (WHO) has a so-called Analgesic Ladder to help explain how pain relievers are best given.  Your pharmacist can guide you through the steps.  Ask also for the series of pain reliever “fact cards” available from pharmacies around Australia providing the Self Care health information.  Phone 1300 369 772 for the nearest location or check out the website and click on “Self Care” then “Find a Self Care Pharmacy”.


Article courtesy of the Pharmacy Self Care Program, an initiative of the Pharmaceutical Society of Australia.


John Bell Column 11 Jul 2012

Pharmacy Self Care Health Facts Column
By John Bell –11 Jul 2012


Taking care of skin

The politically charged problems of climate change and water resource issues in our “sunburnt country” are well known and vigorously debated.  In the past year or so several states in Australia have suffered the consequences of devastating floods.

Certainly not of the same magnitude, but nevertheless discomforting, are personal problems caused by weather conditions.

Winter is usually assumed to be a rainy time of year, but generally the atmosphere is quite dry. The cold weather encourages us to spend too much time in a hot bath or shower, and the harsh soaps we use further strip away the natural layer of protective oils. The result is skin which much more easily becomes itchy, red and inflamed.

Sometimes a skin problem is the first sign of a more serious condition that needs proper and thorough investigation.  Childhood infections like measles and chickenpox may only come to notice by way of the rash that accompanies the other more obscure symptoms; and those supersensitive people amongst us may find that contact with various substances will cause irritating skin allergies.  However, skin problems often result from, or are made worse by, lack of care and attention.

Eczema and dermatitis are two general terms which mean very much the same thing – inflammation of the skin.  Medically speaking there are two major forms of eczema:  contact eczema and atopic eczema.

As the name suggests contact eczema results from direct contact with an irritant substance, often a chemical substance such as detergent, shampoo, cosmetics or the metal in jewellery.  Redness, minor swelling, oozing and itching might all be features of contact eczema.

The cause of atopic eczema is not so easy to define.  It tends to occur in families and is more likely to affect people who also have asthma or hay fever.  Atopic eczema may be made worse by stress.  Sometimes, it may be itchy, red and inflamed with small weeping blisters; sometimes it may be dry and scaly, usually in the creases of the elbows, knees and wrists.

If you have a chronic skin condition such as eczema or dermatitis, avoid the use of soaps altogether.  Instead use soap substitutes – creams such as aqueous or sorbolene cream or the specially formulated Cetaphil or QV range of products.

For skin which is extra sensitive to chemicals, cotton gloves should be used next to the skin, and then rubber or vinyl gloves over the top, when washing or doing work around the house.   Once the rash is under control, the application of a barrier cream will help prevent its recurrence.

Of course skin rashes can occur as a result of any number of different causes.  The rash needs to be correctly diagnosed so that the cause is identified and if possible removed, and the right treatment used. For instance, the commonly occurring skin condition known as psoriasis tends to be more problematic in winter when the itchy, inflamed patches of skin can become painful and bleed. Whilst psoriasis can’t be cured, it can be effectively managed in most cases, and a new prescription product for the especially annoying scalp psoriasis is now available.

Careful exposure to sunlight (but definitely not sunburn) can sometimes improve psoriasis. Just how this and other treatments work is described on the new Psoriasis fact card.

There is also a fact card titled Eczema and Dermatitis which will help you differentiate between one skin problem and another and help you choose the best possible treatment.

These cards along with around 80 others in the Self Care series are available from pharmacies throughout Australia providing the Pharmaceutical Society’s health information.  Phone 1300 369 772 for the nearest location, or log onto the website, click on “Self Care” then “Find a Self Care Pharmacy” .


Article courtesy of the Pharmacy Self Care Program, an initiative of the Pharmaceutical Society of Australia.


John Bell Column 04 Jul 2012

Pharmacy Self Care Health Facts Column
By John Bell –04 Jul 2012


Think you need an antibiotic? Think again

Surely, it will have escaped no one’s attention that this year Queen Elizabeth II is celebrating her Diamond Jubilee; she first came to the throne in 1952. It was some 12 years earlier the experiment which showed the effectiveness of penicillin was carried out.  The results were published in the Lancet in August 1940; and by the end of World War II there was enough penicillin to treat every soldier who needed it.

Most of us alive today have known only one British Monarch.  And indeed most of us have lived in an era where we are able to rely on antibiotics to treat serious infections. Whilst the monarchy in Britain seems likely to continue for the foreseeable future, the future availability of effective antibiotics is not so certain.

The story of the discovery of penicillin is generally pretty well known. In 1928 the Scottish bacteriologist, Alexander Fleming, is said to have luckily noticed that a mould had prevented the growth of bacteria in a dish in his laboratory. What is certain is that it was the team headed by Australian Howard Florey and German Ernst Chain which identified and produced the active antibacterial ingredient. Unfortunately bacterial resistance to penicillin emerged within a few years of widespread use.

Now, due to prolonged inappropriate use of almost all antibiotics, resistance is such a serious issue that the World Health Organization predicts a return towards the health problems of the pre-antibiotic era within a decade. This was a time when safe surgical procedures were almost impossible, when the simplest of cuts and grazes could lead to amputations, and apparently mild respiratory infections would result in death.  It has become urgent to institute more rational use of these critically important medicines.

We all share responsibility; and we can all play a part in what could and should be a solution. Many of us expect, and demand, antibiotics from our doctor for comparatively simple infections which do not need antibiotics. Many of these infections are viral in origin and will never respond to antibiotics in any case.

Inappropriate and unnecessary use of antibiotics causes resistance, not just in the wider population, but also to individuals who take them. Studies show that people prescribed antibiotics are twice as likely to develop their own resistance to that drug.

Effective treatment of symptoms is usually all that’s necessary for respiratory tract infections such as the common cold. Choose products which are specific for your needs; the proprietary combination products are not necessarily the best. Ask your pharmacist to recommend what’s most appropriate.

Of course, you can minimise the need for antibiotics with some simple and sensible lifestyle and behaviour strategies. Make sure your (and your children’s and grandchildren’s) immunisation schedule is up to date. It’s not too late to get a flu vaccine this year.

And help prevent the transmission of infection by regular hand washing, especially before preparing food, and the use of alcohol gels cleansers. If you have to cough or sneeze, do so into a disposable tissue or the bend in the elbow – not into your hand.

This year the National Prescribing Service (NPS) has begun a campaign to encourage us all to become “resistance fighters”. You can learn more about how to get involved at the website You can also get more advice from pharmacies providing the Pharmaceutical Society’s “Self Care” health information. The “fact cards” titled Antibiotics, Colds and Flu, Coughs and Ear Problems are especially useful. For the location of the pharmacy nearest you providing this material, check out the Pharmaceutical Society website ( click on Self Care, then Find a Self Care Pharmacy) or phone 1300 369 772.


Article courtesy of the Pharmacy Self Care Program, an initiative of the Pharmaceutical Society of Australia.


John Bell Column 27 Jun 2012

Pharmacy Self Care Health Facts Column
By John Bell –27 Jun 2012


Taking the pressure off diabetes

Worldwide, the number of adults with diabetes has more than doubled over the past 30 years. According to a study funded by the Bill and Melinda Gates Foundation in conjunction with the World Health Organisation, almost 350 million people now have the fastest-growing chronic health condition. These are sobering statistics at the time of Diabetes Awareness Week (8 -14 July).

Australia is not immune to this epidemic. More than 1 million Australians have been diagnosed as having diabetes; and it’s estimated that at least another 2 million people over the age of 25 have what is known as impaired glucose tolerance or “pre-diabetes”- making them at greatly increased risk of diabetes itself.

Uncontrolled diabetes poses a serious risk to our health. Complications can include blindness, kidney failure and increased risk of heart disease and stroke. In fact, this year, the focus of Diabetes Awareness Week is the relationship between diabetes and a heart health.

Diabetes, commonly called sugar diabetes, is the name given to the condition where our body is unable to use glucose properly – and glucose is our major energy source; the fuel which keeps our body functioning effectively.

There are two major forms of diabetes – type 1 and type 2.

Type 1 diabetes usually occurs in childhood or young adulthood – possibly because the body’s immune system runs a bit wild and attacks and destroys the insulin-producing cells in the pancreas gland. As the body stops making insulin, people with this form of diabetes need daily doses of insulin - by injection or one of the new insulin pumps.

However, type 2 diabetes is the form of diabetes likely to affect most Australians (in type 2, insulin is produced, but we just can’t use it effectively). Type 2 diabetes usually occurs in older adults – it used to be called maturity onset diabetes – but increasingly the condition is affecting younger people. Family history is one reason.

Of course our parents are not totally to blame. Family history is just one risk factor. Lifestyle issues are also highly significant. Overweight and obese adults are two to four times more likely to suffer from diabetes. And we now know that high blood pressure is another major risk factor for diabetes; so controlling our blood pressure will not only reduce the risk of heart disease, but also reduce the risk of diabetes and its serious complications.

Lifestyle changes are the key to reducing the risks of and treating high blood pressure and diabetes, said Dr Neville Howard, President of the Australian Diabetes Council. This should involve healthy eating, regular exercise (30 minutes daily for at least 5 days a week), drinking lots of water, reduced salt intake, alcohol in moderation (no more than two standard drinks per day) and no smoking.

You can check your own risk of becoming a diabetes statistic via the Australian Diabetes Council website: Click on “What is My Risk?”  You can also get more information about diabetes and blood pressure from one of the 1,500 pharmacies around Australia providing the Pharmaceutical Society’s Self Care health information. Phone 1300 369 772 for the nearest location or go to the Pharmaceutical Society’s website at and click on “Self Care” then “Find a Self Care Pharmacy”.

Of course, most of us will benefit from weight loss. Losing 5-7% of excess fat, and moderate exercise two and a half hours per week, will help regulate our blood pressure and reduce our risk of type 2 diabetes by 60%.

Every time we visit the doctor we should get our blood pressure checked. And, especially if we’re over 40, even if we seem otherwise healthy, we should make sure we have at least a yearly check up.


Article courtesy of the Pharmacy Self Care Program, an initiative of the Pharmaceutical Society of Australia.


John Bell Column 20 Jun 2012

Pharmacy Self Care Health Facts Column
By John Bell –20 Jun 2012


Promoting healthy habits for bladder and bowels

Happiness is a clean toilet. Certainly, it’s somewhat distressing, when you need a toilet, and can only find a dirty, smelly one; or even worse, not be able to find a toilet at all. A recent study in the UK has shown that a quarter of pupils in England’s schools avoid using the toilets because of their poor condition and inadequate facilities

According to the Continence Foundation of Australia (the CFA), this is a problem that also occurs in some Australian schools. So, during this year’s World Continence Awareness Week (24 – 30 June), with the theme Healthy Bladder and Bowel Habits, the CFA is launching its “Toilets Tactics Kit” as part of a major project to promote awareness and understanding of healthy bladder and bowel habits in Australian primary schools.

A pilot version of the kit can be viewed on the CFA website:  Amongst other things, it describes how our kidneys, bladder and bowels work and it provides a “school toilet charter” where it lists what we and our children should expect from a school toilet – things such as sufficient toilet paper, water, soap and paper towels or hand dryers.

Poor bladder and/or bowel habits are one cause of incontinence – that is the loss of voluntary control over bladder or bowel function. It’s one of the biggest health issues in the Australian community, affecting nearly four million people.  It may not be life threatening, but incontinence can significantly affect quality of life and is sometimes a sign of more serious health problems.

Signs of poor or weak bladder and loss of urine control include: frequency (wanting to go to the toilet frequently); nocturia (waking up to go to the toilet more than twice at night); urgency (sudden urges to go to the toilet); and the involuntary or unintentional loss of urine from the bladder (that is wetting pants or wetting the bed).

Of course, poor bladder and urine control can happen to anyone at any age. Factors which increase risk are menopause, pregnancy, childbirth, having borne children, being overweight, and urinary tract infections. And while studies show that women are many times more likely to be affected by incontinence than men, men are far less likely to do anything about it.

Simple age-related prostate gland enlargement is often the cause in men.  As well, medical conditions such as diabetes, obesity, constipation and chronic cough can cause or aggravate continence problems.  As we get older, incontinence certainly becomes more prevalent and more severe; but incontinence is not just part of the ageing process.  Certainly some age-related conditions increase the risk – conditions such as stroke, dementia, Parkinson’s disease or simply impaired mobility.

Unfortunately, less than 40% of people with incontinence ever seek professional help. Perhaps because they’re too embarrassed or too busy; or maybe they think nothing can be done; that it’s just a side effect of getting older or having children.

If you, or someone in your family, are affected, firstly get some good advice.  Don’t let incontinence disturb your sleep or, worse still, ruin your social life.  Talk to your doctor, your physiotherapist, your pharmacist or your nurse continence advisor. Bladder and bowel problems can be treated, managed and, in many cases, cured.

Pharmacists throughout Australia who provide the Pharmaceutical Society’s Self Care health information have a series of “fact cards” relating to continence: Bladder and Urine Control, Pelvic Floor Exercises, Prostate Problems and Urinary Tract Infection; all with self-help hints and great advice on how to best manage continence problems, whatever the cause.

To locate the nearest “Self Care“ pharmacy log on to the Pharmaceutical Society (PSA) website at and click on “Self Care”, then “Find a Self Care Pharmacy” or phone PSA on 1300 369 772.

Article courtesy of the Pharmacy Self Care Program, an initiative of the Pharmaceutical Society of Australia.


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