2

THE CHAIRMAN’S COMMENTARY

By Roger Gedye

OUR REFURBISHED SURGERY

I had become quite fond of our

compact Surgery at the top of

the stairs! Now that all is

revealed with the completion of

the ground floor renovation of

Davenport House, patients can

understand how well this

challenging process has been

planned and executed. Our

thanks go to the team of staff,

nurses and doctors who took on

the challenge of providing

patients with an unbroken

quality of service from a fraction

of their normal working space.

This has been a good example

of ‘putting patients first’, a

phrase beloved of politicians

trying to squeeze value for

money from the NHS Budget. I

like to think that a successful

Patient Group can bring together

the needs of both patients and

doctors: helping to improve the

quality of services to patients

and at the same time helping

patients to understand the daily

demands and pressures of the

doctors and their staff.

RIGHTS/RESPONSIBILITIES

Patients have a right to

professional treatment, both

medically and in terms of the

respect they receive from

doctors and staff. In my

experience patients at

Davenport House receive a very

high quality of care, and this is

reflected in the result of

satisfaction surveys carried out

over the years. On the rare

occasions when an error has

been made, or patients feel they

have been poorly treated, there

is a proper procedure to follow.

A formal complaint to the

Practice Manager will be

carefully investigated and the

patient kept fully informed of

the consequences.

Unfortunately there are

occasions when patients forget

that ‘rights’ also carry

‘responsibilities’ –Surgery staff

should be treated with respect,

even when they cannot meet a

patient’s every need.

Receptionists have the toughest

job, trying to match every

patient’s request with an

appropriate (and preferably

rapid) response. Davenport

House runs regular training

sessions for its reception staff,

and has to bring new recruits up

to speed as quickly as possible.

This has been particularly

evident in the last few months

following the departure of three

experienced team members.

Perhaps it is natural to take the

service offered by the

receptionist for granted,

particularly when one is feeling

unwell, but the occasional word

of thanks is greatly appreciated

by the staff.

GOOD NEWS

Let me end on a positive note.

A Davenport House patient

waiting to see the doctor was

overcome by her illness and

was close to passing out.

While one receptionist brought

her a glass of water and words

of support the other located an

empty consultation room with

a couch, where she was visited

and treated by her doctor. A

small matter but handled with

tact and sympathy, greatly

appreciated by the patient. I

hope that this is typical of your

experience too.

Vitamin D Deficiency 3

Surgery Refurbishment 4/5

Be Clear on Cancer 6/7

Dr Stranders to retire 8

Patient Meeting Reports 9 /10

Medical Myths 11

Surgery Timetable 12

Inside this issue:

SOME LIGHT MEDICAL RELIEF – Dr Stranders

Did you hear about the girl

who insisted on taking her

pill with a glass of water

from the River Mersey?

She’s now three months

stagnant!

“You’ve got to help me”, cried the man rushing into

the psychiatrist’s – “I keep on thinking I’m a dog”

“I see. Well just lie down on the couch for a moment”

“I’m sorry, I’m not allowed on the couch”.

3

A LITTLE BIT OF SUNSHINE CAN BE GOOD FOR YOU

By Dr Alka Cashyap

It was a typical Monday morning

at the Surgery. I was already

running twenty minutes behind,

yet I was in no hurry to call in

Mrs Green. Why, I wondered, as

I looked through her notes, was

I not able to make a diagnosis

for her? I looked at all the

investigations I had carried out

on her - the blood tests, the X

rays, and even a bone scan.

I read through her symptoms.

Pain across the shoulders. Pain

in the thighs. ‘My ribs hurt,

doctor, and I feel so weak and

lethargic’. I knew she wasn’t

making it up, she just wasn’t

that kind of lady.

I scrolled through her notes

again and again, almost chewing

my nail off in the process.

Suddenly, an article I had read

last week from one of the

medical journals popped into my

mind! Could it be?

I called Mrs Green in with a

smile. Her complaints had not

changed. I printed off a request

for a blood test, and asked her

to have it done.

Her results came through a few

days later and a feeling of

elation came over me when I

saw them. My hunch had been

right! Mrs Green had Vitamin D

deficiency!

‘I am so disappointed to hear

that, doctor,’ said Mrs Green.

‘I eat such a healthy diet’.

I told Mrs Green that 90% of the

Vitamin D that we need comes

from the sun, and the rest

comes from the diet. Twenty

minutes of exposure to the

midday sun three times a week

will allow our skin to make

enough Vitamin D for the day.

Staying in the sun for longer

without sunscreen does not

make the skin make more

Vitamin D and increases the risk

of sun burn and skin cancer.

Eating oily fish such as salmon,

mackerel and sardines, and

eggs and meat also help. In this

country, margarine and some

cereals are fortified with Vitamin

D.

Luckily, Mrs Green only had a

mild Vitamin D deficiency. She

took supplements for a few

months but then made sure she

changed her lifestyle and

exposed herself to the sun as I

had advised. Six months later,

she felt like a new woman!

Not surprisingly, she was keen

to tell all her friends about her

new diagnosis and asked me if

she should advise them all to

see their GP? I advised Mrs

Green to encourage her friends

to expose themselves to

sunshine as I had told her to,

and to eat a sensible diet. For

most people that is enough. The

recommended daily dose for the

average adult is just 10

micrograms per day, and there

are some over the counter

supplements available. Her

friends could certainly see their

own GP to talk things through

but routine testing is not really

recommended. And, of course,

one needs to remember that

aches and pains do have other

causes.

Current research suggests that

approximately half of the adult

population are deficient in

Vitamin D, particularly in the

winter. People at risk of Vitamin

D deficiency are the elderly,

pregnant women and children,

dark skinned people and people

who stay indoors or keep

themselves covered up.

A programme for some at risk

groups, such as children under

five and pregnant women, is

being sorted out, so that they

will get a daily supplement. But

for the rest, the Department of

Health is hoping that we will all

become more aware of this

condition and make the

necessary lifestyle changes so

that the situation does not get

out of hand. THE MESSAGE IS:

A little bit of sunshine is

definitely

good for

you.

4

OUR UPGRADED SURGERY OPENS

By Heather Hassall, Practice Manager

Almost all of the refurbishment is now complete

with the re-opening of the ground floor. From 20

February 2012 the 6 consulting rooms and 3

treatment rooms on the ground floor were

available for use. Also open are the main

reception desk,

reception office

and the staff

meeting room.

The main

entrance doors

at the front of

the Surgery are

double sliding

doors, which

should provide

easier access for everyone. In the winter these

have a hot air blower and together these should

reduce the heat loss. During the summer months

the doors can be set to be permanently open.

A new facility is the interview room. This can be

used to talk privately to a receptionist if

necessary, or could be used for breast feeding

mothers, or potentially infectious patients. It

also contains a baby changing unit.

The layout of the ground floor is similar to the

first floor, with a separate corridor between the

waiting area and consulting rooms to help

maintain confidentiality in the consulting rooms.

The 7

consulting

rooms on the

first floor

continue to be

available and

the temporary

treatment

rooms on the

first floor have

now reverted

to administrative office space, as was the original

intention.

Patients should check-in for their appointments

on the ground floor at reception or via the self

check in system. At this point there will be

information on whether their doctor is located on

the ground or first floor. There are signs to

locate the consulting rooms from reception. The

refurbished lift will provide easy access for

buggies and wheelchairs.

There are still some finishing works to be done:

the delivery of new waiting room furniture, leaflet

racks and possibly patient information screens.

There is continuing upgrade work in the building

with the redecoration of the stairs and landings.

New carpet will also be laid in these areas.

Finally, the temporary constructors’ unit beneath

the building will be removed and the staff car

park repainted and enclosed. This work is due to

be finished around the end of March.

The past year

has been

difficult at

times for

patients,

doctors and

staff with

changes to

Surgery times,

drilling and

alternative

routes into the

building.

Overall this

upgrade has

aimed to make

the best

possible use of

space and

ensure that the

Surgery meets the latest standards for a medical

centre. We would like to thank all patients for

bearing with us and hope that, like us, you will

feel that the disruption was well worth the

outcome.

Please contact the Practice Managers if you

have any queries or comments. (01582

463007)

THE NEW TREATMENT ROOMS

All nurse appointments are now held downstairs

in the new treatment rooms.

This layout on one floor is of great benefit as all

the equipment, stock items and paperwork can

be stored in one place for quick access saving

time for the whole team, It is also much easier

for the nurses to communicate with each other

for the benefit of improved patient care.

There are also three fridges which during the flu

season will make it so much easier to store the

vaccines without worrying if there will be

enough room for the travel and childhood

immunisations. We are confident that these

more spacious arrangements will make access

easier for all our patients.

Ground Floor Reception

Doctor’s Consulting Room

Ground floor waiting room

with reception on the left

5

GROUND FLOOR PLAN OF SURGERY

FIRST FLOOR PLAN OF SURGERY

Doctors’ Consulting rooms

Nurses’ Treatment rooms

Utility rooms

Front Entrance

Reception

Waiting Area

Lift

Lift

Waiting Area

Corridor leading to Treatment and Consulting Rooms

Corridor leading to Consulting Rooms

Dr Sandler 3

2

1

Treatment Rooms C B

Treatment Room A

Toilets

Dr Cashyap 4

Dr Chafer 5

Staff

Meeting Room

Dr Stranders 6

Administrative Offices

Interview Room

Orthodontist

Administrative Offices

Toilets

Dr Barber- Lomax

14

Dr Wadhwani 12

11

9

Dr Thenuwara

10

Dr Lamb

8

Consulting Room 7

Administrative Offices

Toilets

Lift

6

BOWEL CANCER

A new campaign has been

launched to encourage

people to report possible

early signs of bowel

cancer. It is well

recognised that if we can

spot the signs of cancer

early then outcomes are

better. In other words

treatment is easier and

more effective and our

chances of having the cancer cured are better.

So the message for bowel cancer is:

If you’ve had blood in your poo or looser

poo for 3 weeks, your doctor wants to

know. Now many people feel very embarrassed

to come to see us to talk about ‘poo’, ‘motions’,

‘stools’ or whatever other name we use for

faeces.

But our bowel is just another part of the human

body. Doing a rectal examination is therefore the

same as examining any other part of the body

for us as doctors but more embarrassing for us

as patients. As GPs we will work hard to put you

at your ease. The examination usually takes only

about 1-2 minutes. If after examination we do

have concerns that ought to be addressed by

further examination, we will make a referral for

you to have other tests such as colonoscopy

where a flexible tube is passed through the anus

to reveal the whole colon.

So this is a national campaign by the Dept. of

Health to look at bowel cancer but we ourselves

can also look out for the early signs of other

cancers and there are resources to help us.

Cancer Research UK offers excellent guidance

www.cancerresearchuk.org

OTHER CANCERS

Considering other cancers this is the situation in

the UK.

So why try to spot cancer early?

1 in 3 people will develop some form of

cancer during their lives

Cancer is much commoner as we get older

9 out of 10 cancers occur in people over 50

years

The earlier cancer is diagnosed the better the

survival rates

Survival from cancer has improved

dramatically

230,000 cancers diagnosed each year and

120,000 cancer deaths each year.

BE CLEAR ON CANCER

By Dr Kirsten Lamb

Returning therefore to what to look out for

having decided that it is worth it – here is a crib

sheet.

The lump – for women the scariest is finding

a breast lump but other lumps are also

important to check out. So for men checking

for lumps in the testicle is important.

Funny moles – the ones where the colour or

shape changes or they start itching or

bleeding.

Stubborn sores – the ones that won’t heal

after several weeks.

Tongue and mouth ulcers – especially the

ones that last longer than 3 weeks.

Difficulty swallowing and that indigestion

that won’t go away

The hoarse voice and the cough that won’t

go away – again especially lasting longer

than 3 weeks and particularly if you are a

smoker.

Blood in the wrong place – blood in ‘poo’ as

per the first message but also blood in ‘pee’

or urine, vaginal bleeding that is odd or

occurs after the menopause.

7

There are more than 200 different types of

cancer but being aware of these features will

help to spot things early.

CARE WITH SYMPTOMS

It is important to remember however that this

guidance points out the presence of the unusual

feature for 3-4 weeks before getting concerned.

Most of us will suffer the whole range of the

symptoms listed above but they will last a very

short time and be nothing to worry about. Being

vigilant must be balanced with avoiding getting

over anxious about everything that happens to

us. Hopefully we can help you differentiate the

important from the less important when we

discuss your concerns in Surgery.

CANCER SCREENING

We can also spot early cancer by screening. In

the UK at present there are 3 different cancer

screening programmes.

Cervical Cancer Screening:

All women are offered a smear every 3 years

from the age of 25 to 49 and then every 5 years

from the age of 50 to 65. The intention is that

women receive their smear result within 14 days.

Breast Cancer Screening:

Those of us over the age of 50 years will be

accustomed to our outings to the caravan in the

Amenbury Lane car park. The caravan tours the

district arriving in each town once every 3 years.

Women are invited every 3 years from the age of

50 until 70 years. As the mammography caravan

only comes 3 yearly a first mammogram may

occur close to a woman’s 53rd birthday. An

extension of the age range is being phased in

across the UK and will be fully in place by 2016.

The new age range will be from 47 to 73 years.

Bowel Cancer Screening:

Most people aged between 60 and 70 will by now

have received a first bowel cancer screening kit.

The test is based on looking for ‘faecal occult

blood’. Many cancers in the bowel produce tiny

amounts of blood - occult means hidden so the

test looks for blood in the stool that you cannot

see with the naked eye. Those of you who have

already done the test will know that you receive

a kit in the post. The kit asks you to spread some

‘poo’ on a card using a stick on 3 different days.

You then post the completed card back to the

screening unit. The screening programme will be

extended up to the age of 75 years. People are

sent kits every 2 years whilst within this age

range.

So be sensible and avoid burying your end

Difficulty passing urine.

Odd weight loss (your clothes become

looser but you have not been dieting) or

odd night sweats.

Changing bowel patterns especially much

looser.

Unexplained pains or aches that go on for

longer than 4 weeks.

Overcoming fear and embarrassment will help

and we can support you in doing that.

Remember too that you can reduce your risk of

cancer by:

Stopping smoking – smoking is the worst

offender in terms of cancer risk accounting

for 1/3 of all cancer deaths

Eating a healthy diet – remember the 5 a

day message

Having a normal weight

Getting plenty of exercise

Having the cervical cancer immunisation as a

school girl

Avoiding excessive sun exposure

Being aware of your family history and

therefore whether you need to be more

vigilant.

So good luck and remember we are always

happy to talk with you about anxieties you

may have about cancer.

8

MY RETIREMENT

By Dr Alan Stranders

5 October 2012 will be a ‘red

letter day’ for me. I reach the

ripe age of 65 and can thus

draw my old age pension AND I

will be retiring as a General

Practitioner from my Partnership

at Davenport House.

I joined the Practice [then at the

Borodale premises in Kirkwick

Avenue] in September 1974,

when Dr Edgar Whitby was the

Senior Partner. I was

apprenticed to him until April

1975 when he retired, and I

took over his list of registered

patients. This 6 months under

his tutelage was a rapid learning

curve, and a memorable

experience for me. Edgar was

undoubtedly a GP of the old

school’ where ‘Doctor knows

best’. This was rather different

to my Middlesex Hospital

Medical School training which

focused on patient-centred care.

I was subsequently taken into

full Partnership and my wife,

Andrea, and I settled in to the

busy life of a Harpenden GP.

This entailed regular Surgery

consultations [much as now],

home visits, nights and

weekends on-call for the

patients of the Practice.

At this time it included

delivering babies with the

attending midwives at patients’

homes, or at the Maternity Unit

at Harpenden Memorial Hospital

[The Red House]. In addition,

we looked after the Hospital’s

Casualty Unit and our own in-

patients. All these services are

now defunct since the closure of

the GP clinical departments at

the Red House [under a

previous NHS rationalisation!].

In those days, the Harpenden

GPs ran the Hospital via the

Medical Staff Committee, with

the help of ONE Hospital

Administrator. We usually kept

the running costs within the

given annual budget, and with

high efficiency, due to the

expertise of the loyal and

dedicated Hospital staff.

In 1979 the Practice moved to

its present site, Davenport

House, which were revolutionary

new purpose-built premises.

Indeed, these premises won

awards for architectural and

functional design of an up-to

date GP Surgery.

That was over 30 years ago,

and we have now acquired our

new, modernised and totally

refurbished Davenport House.

Again, I believe this is a model

for GP Surgeries for the future.

I have been privileged to work

here in Harpenden, still

affectionately known to many as

The Village. I have enjoyed my

professional career as a GP

immensely. For this, I must

thank all the staff both past and

present who have enabled me

to work without undue

interruption. They have always

been conscientious, helpful and

efficient in their duties,

attributes I am sure many

patients will also recognise.

I have also been helped

throughout by other health

professionals: District and

Macmillan Nurses, Health

Visitors, Physios, Social

Workers, Counsellors,

Complimentary Therapists, all

the various Hospital staff, and

many, many others too

numerous to mention. All these

professionals oil the cogs of our

health system and whose

goodwill, to a large extent,

keeps it running.

I must sincerely thank my

Partners, both past and present,

for putting up with me for the

best part of 40 years, despite

my personal foibles and my

passion for golf! It has been an

honour to be working alongside

you all in partnership,

companionship and fellowship.

Just like being married really

[but without the sex!!]. And

yes, thank you Andrea for

always being there to support

me and the Practice all these

years.

And finally, and most

importantly, I must thank you,

our patients and your families,

for allowing me into your lives

and your hearts, and for

entrusting your medical care to

me over so many years. I shall

truly miss you.

9

PATIENT GROUP MEETING REPORTS

By Sheila Uppington

GETTING THE MOST FROM YOUR GP

CONSULTATION

Dr Andrew Chafer gave a detailed analysis

of surveys into the GP/Patient relationship

and how to get the best from your

consultation. His talk at the AGM on 6

February was illustrated with excellent

slides and was extremely informative.

As a GP

consultation is

the cornerstone

of health care,

and 90% of NHS

contacts are via

a GP, it is

important that

both the doctor

and the patient

communicate

with each other

effectively.

Patients want more involvement with decisions

and to achieve this successfully both doctor and

patients need to be aware of potential 'barriers'.

POTENTIAL BARRIERS

Poor GP/Patient relationships. Perhaps one-

sided with the doctor taking control of the

consultation too early without listening out for

'indirect' clues to worries.

Inadequate training of doctors. Failing to ask

questions correctly, not listening for answers

and not thinking of the whole patient as well

as the disease.

Time constraints on consultations which

include patients bringing too many demands

and issues to one appointment

Increasing number of consultations rising

71% in 15 years without budgets to match,

and hospitals devolving complex care to GPs.

Not turning up for appointments and failing to

cancel.

Being realistic of expected outcomes e.g.

requests for letters to be written immediately.

OTHER CONSIDERATIONS

It's now been realised that patients can

remember what they are advised as long as not

too much medical jargon is used or too much

detail is delivered too fast. Patients are often

well-

informed and

may

disagree so

practitioners

may need to

have a

dialogue.

Doctors feel

under time

pressure to

diagnose and

treat and

often have most trouble when wrapping up some

consultations. Particularly with the 'hand on the

door knob' syndrome and the patient on exiting

saying 'Oh, by the way.......

SOME TIPS FOR YOUR CONSULTATION

It is helpful for patients to plan what they want

to say:

Think of your problems as a narrative

(Patient Association leaflet - You &

Your Doctor - is useful)

Write your concerns down, state worries

clearly, take someone with you as a second

pair of ears.

Don't be frightened to speak up and ask to

finish if not all your questions have been

asked.

Then take any medicine correctly. £1/2

billion is lost per year through failure of this

plus the extra time of further appointments.

Any differences and disagreements between

the doctor and patient should be aired and

discussed, and both need to take their share

of responsibility so that the relationship

becomes more interactive.

These will be important in the future as the

strain of an increasing and aging population

may mean some face-to-face consultations are

replaced by telephone or other technology.

Patients may be allowed access to their records

to up-date details such as blood pressure, and

may have to take more responsibility for

managing their illness. So:

USE YOUR CONSULTATION TIME WISELY!

10

PATIENT GROUP MEETING REPORTS

By Sheila Uppington

MUSCULOSKELETAL ISSUES

Responding to patients' questions at a

Small Group meeting on 8 December 2011

Dr Charli Barbar-Lomax explained some

common problems in this area.

How and why spinal fusion of vertebrae was

needed,

Muscle problems related to taking statins and

although these were rare how they could be

overcome.

How loss of height with age affected organs.

He also covered in detail various pain-coping

regimes associated with osteoarthritis.

Dr Alka Cashyap

followed on with a

demonstration &

explanation of how

acupuncture could be

helpful to some muscular

skeletal problems.

The philosophy is based on

energy flows through

channels being blocked by

disease which can be

released by stimulation from needles in various

parts of the body. Although it does not work for

all, some find it a helpful complement to

traditional remedies.

A lively discussion continued throughout the

evening by the end of which patients felt much

reassured.

PRESCRIBING MATTERS

Dr Chas Thenuwara gave a talk at the AGM

on 6 February 2012 on prescribing issues.

There are various constraints that affect what a

doctor can prescribe.

The General Medical Council guidance -

drugs must be appropriate and in the

patients' best interests (not simply because

of patient demands or convenience).

Effective treatment must be based on the

best available evidence.

There must be a reasoned argument for

refusing to prescribe in particular cases and

doctors must have adequate knowledge of

the patient.

Locally the Herts Medicines Management Group

provide guidelines accommodating the current

financial constraints. They have an ethical

framework so that all patients are treated fairly.

Their decisions like others are based on evidence

of clinical effectiveness. Other national bodies

such as NICE also issue prescribing policies, at

times hotly discussed in the media.

Doctors are aware of prescribing limitations but

keep an open mind when responding to an

individual’s needs.

We occasionally close the Surgery from 12-5pm

to complete staff training. These afternoons are

coordinated throughout the area and allow

Surgeries to either come together for locality

training or to arrange something specific for the

Surgery. Training days include staff and clinicians.

Topics covered in the afternoon have included:

Basic life support and defibrillator

Information Governance

Child protection

Health and safety awareness

Let’s use it right- signposting patients to the

right services. Clinical pathways for care

The confirmed dates for training during 2012 are Thursday 8 March, Thursday 28 June, Tuesday 11

September, Wednesday 14 November.

Whilst we apologise for the inconvenience of

closing the Surgery for 4 hours, these training

afternoons are valuable in keeping the whole

Surgery team up to date.

SURGERY SNIPPET

To make resources go further we as patients

should:

Use pharmacists more by buying over-the-

counter drugs for minor ailments.

Reduce wastage by taking prescribed drugs

Listen to Government health promotion

advice (prevention better than cure!)

Be aware that generic branded medicines

are just as effective but cheaper than

branded ones.

Reduce inappropriate requests to our GPs.

11

PATIENT GROUP ANNUAL GENERAL

MEETING – Monday 6 February 2012

Over 50 members attended the Patient Group

AGM and approved re-election of the Chairman,

Roger Gedye, and all committee members listed

below, there being no other nominations. The

audited accounts were also approved. Minutes of

the AGM and the audited accounts can be found

on the website:

www.davenporthouseppg.org.uk

PATIENT GROUP COMMITTEE

Roger Gedye Chairman

Ian Drew Treasurer

John Harris Newsletter Editor

Helen Hartley Membership Secretary

Rosemary Horne Secretary

Samantha Mills Younger patients

Malcolm Rainbow External health affairs

Sheila Uppington Education

Viviane Vayssieres Marketing

Contact details can be found on the

Patient Group website as above.

SOME MORE LIGHT MEDICAL RELIEF

By Dr Alan Stranders

A man went to his GP complaining of a pain in

his stomach. The GP performed a thorough

examination but could not find anything

obviously wrong. “I’m afraid I can’t diagnose

your complaint – I think it must

be drink”.“All right then,” said

the patient, “I’ll come back

when you’re sober.” A woman went to her GP and told him “every

time I sneeze, I have an orgasm”

“Hmmmm. What are you taking for it?”

“Pepper,” she replied.

Patient: Doctor, doctor! This swelling on my

leg’s getting so big I can’t get my trousers on

GP: Very well, then – take this.

Patient: Is it medicine, doctor?

GP: No, it’s a prescription for a

kilt!

Eating lots of Carrots will improve

your eyesight

This is a common myth. Carrots

are rich in beta-carotene, which

the body converts to Vitamin A.

Vitamin A deficiency causes

night blindness; an extreme

deficiency can even cause

blindness. Vitamin A deficiency

is the commonest cause of

blindness in the Third World

BUT if you’re not deficient

(which is extremely likely in the UK) your vision

won’t improve no matter how many carrots or

other beta-carotene fruits and vegetables you

eat.

In fact excessive amounts of beta-carotene can

turn your skin orange, although this is a

temporary effect.

The myth seems to originate from World War 2.

The British Intelligence service spread a rumour

that their pilots ate a lot of carrots and that’s

why they were so successful hitting German

targets. Actually they had superior radar

surveillance!

Cholesterol is bad for you

There is a "bad" and a "good" cholesterol. Bad

cholesterol known as LDL is found in saturated

fats such as red meat and cheese. Good

cholesterol known as HDL is found in

monosaturated fats such as oily fish (salmon/

herring/trout) and seeds. Good cholesterol helps

transport cholesterol away from the arteries,

back to the liver.

If you have a cholesterol test often both LDL &

HDL readings are made available. Often we use

the ratio of the total cholesterol versus HDL to

give a better picture of someone’s cholesterol.

Diet has an important factor in cholesterol levels.

Unfortunately genetically some of us are more

prone not to metabolise fat efficiently and

despite our best efforts we still have high

cholesterol and may be put on a statins. Rarely,

some families have a genetic condition which

affects the way cholesterol is made in the body.

Total cholesterol (TC) should be less than 5 and

HDL more than 1.2. Ideally the ratio of TC to

HDL should be less than 5 or even lower if you

have other risk factors for heart disease e.g high

blood pressure, smoking or diabetes. Statins

work by blocking an enzyme in the liver that

make cholesterol.

SOME MORE MEDICAL MYTHS

By Dr Chas Thenuwara

12

One of the major changes in the last few months during the premises refurbishment was to the

Surgery times with more GPs starting at 7am and many running lunchtime surgeries. Feedback

from patients suggests that some lunchtime provision would be an excellent enhancement to our

services and so, we have adapted the GPs’ working days to accommodate some middle of the day

working. The new system works on a two weekly cycle so that we offer a good mix of times - early

starts, lunchtimes and early evening.

Other changes include two reception desks: one on each floor. The intention is for the main desk to

be downstairs by the main entrance doors so that it is readily accessible to all visitors and we

encourage patients always to enter the Surgery through the automatic doors so that they can check

in either at reception or on the touch screen machine. The reception upstairs will normally only be

manned by one receptionist and so patients may find they are better served by using the main

reception to check in and book future appointments . The new doors are fully automatic and the lift

has been enhanced to give disabled access so we will be able to accommodate all our patients.

However, if you would prefer to be seen on the ground floor, please let us know when booking and

we will accommodate your request.

We have included a baby changing area in the interview room on the ground floor. If your baby

requires changing or feeding whilst in Surgery, please ask a receptionist who can guide you.

We do hope that you will find the new premises easy to use but would appreciate your feedback as

we are always keen to improve our services for our patients.

SURGERY TIMETABLE

By Anthea Doran, Practice Manager

Open Meetings at Fowden Hall, Rothamsted on Monday evenings starting at 8.00pm

Monday 14 May Weight Management

Monday 2 July Sports and Exercise Injuries

Monday 8 October Health Screening

Informal Group Meetings at the Surgery starting at 7.30pm by member application.

Tuesday 12 June Holiday Diseases & Vaccinations The Nursing Team

Tuesday 6 November Issues of Fatherhood Mrs Barber-Lomax

Tuesday 4 December Home First Aid Jill Hutchinson - The Red Cross

FURTHER DETAILS IN SUBSEQUENT NEWSLETTER AND BY SEPARATE FLYER

2012 PATIENT GROUP DATES FOR YOUR DIARY