Health A – Z

Having fluids administered directly into a vein while under the influence of alcohol will not make you feel better any more quickly.

See the NHS website for further information on the effects of drinking. alcohol.

When discussing treatment for adult schizophrenia with your doctor or specialist nurse, you or your advocate should consider whether medications taken by mouth or longer-acting medications given by injection would be better for you.

See the NHS website for further information on treating and living with schizophrenia.

Back pain is common and effects most people at some point in their lives. If you have back pain and there are no other concerning features (such as compression of the nerve roots) you are unlikely to need investigations such as X-rays.

The NHS website has detailed information on back pain and what you can do to help yourself to prevent and care for back pain.

You should only receive a blood transfusion if it is really necessary, such as for major bleeding or severe anaemia, and not if alternatives are available such as iron treatment if you have iron deficiency anaemia. As an adult, you should only receive one unit of blood at a time unless you are bleeding heavily.
You should be provided with information about the benefits and risks of blood transfusion and have the opportunity to ask questions.

More information on blood transfusions can be found on the NHS choices website. 

You should only receive a blood transfusion if it is really necessary, such as for major bleeding or severe anaemia, and not if alternatives are available such as iron treatment if you have iron deficiency anaemia. As an adult, you should only receive one unit of blood at a time unless you are bleeding heavily.
You should be provided with information about the benefits and risks of blood transfusion and have the opportunity to ask questions.

More information on blood transfusions can be found on the NHS choices website. 

Small fractures of the base of the fifth metatarsal, a bone on the outside of the foot, do not usually need to be put into a plaster cast as they will heal just as quickly in a removable boot.

More information on caring for broken bones can be found on the NHS choices website.

Calcium testing is used when there are symptoms of kidney stones, bone disease or nerve-related disorders. It is not necessary to have a test if you have had one within the last three months unless you undergo major surgery or become seriously unwell.

More information on calcium and how to get the right amount can be found on the NHS choices website.

There is no one way to come to terms with a life-threatening illness. Decisions about your care must always suit your own personal beliefs and circumstances.

Terminal cancer will often involve difficult decisions about your quality of life versus longevity. The decision as to what treatment is best for you will always be yours, and it is important that you discuss it fully with your loved ones, doctors and specialist nurses.

Patients with cancer that cannot be cured are frequently treated with palliative chemotherapy. This is sometimes used to shrink the cancer or to eliminate distressing symptoms. A patient’s individual response to these powerful drugs depends on the nature of their tumour. As more and more different types of chemotherapy are used, a meaningful response becomes less and less likely. Furthermore, if one type of chemotherapy has failed altogether, then it is unlikely a different type of chemotherapy will work either.

Chemotherapy is by its very nature toxic. Therefore the combination of failing to achieve a response and causing toxicity can ‘do more harm than good’. Finally, the use of chemotherapy with a low chance of a meaningful response can raise false hopes.
If you have advanced cancer, the use of chemotherapy where the benefit is likely to be small and the harm may be great should be carefully considered.

Similarly, if you are receiving palliative chemotherapy or radiotherapy, post-treatment CT scans or Magnetic Resonance Imaging (MRI) are unlikely to be of benefit to you or influence the decisions of the team looking after you. What really matters is how you feel and whether your symptoms improve after the treatment.
The NHS Choices website has more information on cancer and end of life care.

If you have an uncomplicated cataract operation, then you do not need to be reviewed by your doctor the day after your operation.
For more information on cataracts see the NHS choices website

The NHS Shared decision making aid on cataracts may help you choose the right decision for you and help with conversations with your doctor and optician.

Small fractures on one side of the wrist, commonly known as ‘buckle fractures’, do not normally need a plaster cast. They can usually be treated and get better just as quickly with a removable splint accompanied with written information for care. There is also usually no need for follow up in a fracture clinic.
More information on caring for broken and fractured bones can be found on the NHS choices website.

In most cases, bronchiolitis, which is an inflammation of the small breathing tubes in the lung, gets better without treatment. Although seeing your child with breathing difficulties can be distressing, acute bronchiolitis should not be treated with medications called bronchodilators, which cause a widening of the small breathing tubes in the lung, as they have been shown to have little or no effect.

NHS choices gives more information on identifying and treating bronchiolitis at home and when to take to your child to the doctor.

Polyethylene Glycol should be used in preference to Lactulose in the treatment of chronic constipation in children.

For more information on constipation the following websites provide explanations and ways to help relieve the symptoms.

The NHS choices website on constipation.
Patient website on constipation in children.

If your child is having a prolonged seizure, giving medications (such as Midazolam and Lorazepam) which can be dissolved in the mouth are preferred to medications which are injected or administered by means of a suppository. This is because there is good evidence too, that medications which can be dissolved in the mouth are just as effective, easier to administer and patients and families usually prefer them. This route may also stop seizures sooner, resulting in fewer admissions to hospital and less admissions to intensive care.

For more information on epilepsy see the epilepsy society website.
The Medicines for Children website has more information on oral treatments for stopping seizures.

Helmet therapy is not effective in the treatment of plagiocephaly, which is also known as flat head syndrome, other treatment options should be considered and discussed with your doctor or specialist nurse, such as adjusting your child’s sleep patterns, ‘tummy time’ and physiotherapy.

More information on plagiocephaly symptoms and treatments can be found on the NHS Choices website and the Great Ormond Street Hospital for Children website.

If a child under 12 months old has a recurrent sticky eye and a suspected blocked tear duct, surgery to unblock it is not required until they are over 12 months as it commonly resolves prior to this.

If conjunctivitis is thought to be viral there is no need to send samples to the laboratory or to treat with antibiotics.
For more information on conjunctivitis see the NHS choices website

If you have a coil (intrauterine device, IUD) fitted to prevent pregnancy, you should be taught to check its placement by feeling the threads inside the vagina. This should be done regularly in the first month after it has been fitted and then after each of your periods or at regular intervals. You only need to seek professional advice when you cannot feel the threads.

NHS choices website provides more information on the coil and how to check it is still in place.

Studies have shown that drinking quality tap water is just as effective for cleaning and washing cuts and grazes as sterile saline solution.

The NHS choices website provides more information on caring for cuts and grazes.

Cochrane Review: The effects of water compared with other solutions for wound cleansing.

Routine screening programmes do not exist for dementia. If you think that you or someone you care for are displaying symptoms you should speak to your doctor.

The NHS choices website on dementia gives more information on spotting symptoms and what do next.

If your depression is being treated with antidepressants as prescribed by your doctor and you do not feel that these are effective, your medication should be changed or another medication added, which will work in parallel with the initial drug that was prescribed.

For more information on antidepressants see the NHS choices website.

The NHS also has a decision aid to help you decide with your doctor what course of action is best for you.

Sometimes, being maintained on life support will not result in a recovery that is meaningful to you. Similarly if you are caring for someone in this situation you should have a discussion with the patient (if that’s possible) as well as with specialist clinicians about the goals that can be achieved through further treatment.

NHS choices website has an end of life care guide to provide you with more information on planning for end of life care.

If you are particularly frail or have been told you have less than a year to live you should try to decrease the number of medicines you take to only those used to control your symptoms.

The NHS Choices website has lots of information on end of life care and your wellbeing, to help you make the right decisions about your care.

You should only be considered for medication to treat high blood pressure, to prevent heart disease and stroke, if you have other risk factors and blood pressure readings consistently above 140-159/90-99.

For more information on high blood pressure see the NHS Choices website.
The NHS also has a decision aid to help you decide with your doctor what course of action is best for you. 

If you are taking a statin, which are often prescribed to lower levels of low-density lipoprotein (also known as ‘bad cholesterol’) at the recommended dose, you do not need to have your cholesterol levels routinely checked unless you have had pre-existing conditions such as a heart attack, stroke or a family tendency towards problems with high lipids.

For more information on high cholesterol see the NHS website.
There is also a NICE decision aid for helping to reduce cardiovascular disease including lipid modification which may asssit discussions with your doctor.

Some injuries, such as hip and shoulder dislocations, can be treated under medications which make you feel a little drowsy (sedation) rather than put you to sleep (general anaesthetic). This means you may not have to go to the operating theatre and can be treated in the A&E.

The NHS choices website has more information on dislocated shoulders and dislocated kneecaps.
It also provides full explanations of anaesthetics.

If you are over 45, you do not usually need blood tests to diagnose the menopause. Typical symptoms include hot flushes and sweats and your periods may be much lighter or irregular in nature.

The NHS choices website provides full information on identifying symptoms and treatments for the menopause.

If you are planning a pregnancy or may be pregnant, you should not be prescribed sodium valproate for the treatment of epilepsy, migraine or bipolar disorder unless other medications are not working. If sodium valproate is prescribed, this should only be done after a full discussion of the risks and benefits to you and your unborn child.

More information on taking valproate while pregnant can be read in the Valproate patient guide.

If you have experienced unexplained or recurrent miscarriages, medicines like aspirin, heparin or progesterone should not be used to reduce the risk of further miscarriages.

The Royal College of Obstetricians and Gynaecologists provide detailed information on bleeding and/or pain in early pregnancy and recurrent and late miscarriages.

If you have a simple ovarian cyst of less than 5cm in diameter, and have not undergone the menopause, you are unlikely to need a follow up appointment or have levels of a protein called Ca-125 checked.

The Royal College of Obstetricians and Gynaecologists provide detailed information on ovarian cysts before the menopause.

If your doctor suspects you may have polycystic ovaries, you should have a blood test to look for the typical hormone pattern before further investigations.

The Royal College of Obstetricians and Gynaecologists provide detailed information on what polycystic ovaries mean for your long-term health.

If you are pregnant, aspirin is not recommended as a way of reducing the chances of developing blood clots (thromboprophylaxis).

NHS Choices website provides more information on aspirin.

Unless you have diabetes or develop gestational diabetes during pregnancy, ultrasound scans should not be used to check if your baby is bigger than normal for its gestational age (macrosomia).

The Royal College of Obstetricians and Gynaecologists provide detailed information on gestational diabetes.

Electronic monitoring of your baby’s heart is only needed during labour if you have a higher than normal risk of complications.

The NHS Choices website has more information on the stages of labour. 

Unless you are at risk of prostate cancer because of race or family history, testing for a specific protein produced by the prostate (Prostate Specific Antigen – PSA) does not necessarily lead to a longer life.

There is a misperception that early testing of PSA is always of benefit in detecting prostate cancer in its early stages. There are important trade-offs between the potential benefits and harms involved with either testing or not testing for prostate cancer and a lack of evidence on testing outcomes. Potential benefits include earlier diagnosis of prostate cancer but potential harms include additional hospital visits, tests, anxiety and over diagnosis (the identification of prostate cancer that would never have caused symptoms in the patient’s lifetime, leading to unnecessary treatment and associated adverse effects). It is particularly important that patients make informed decisions about the value of having the test.

The NHS decision aid can help you decide with your doctor if the PSA test is the right choice for you. 
Prostate Cancer UK provide more information on the PSA test

Scans of the head (CT or MRI) can only be used to help diagnose psychosis in specific situations and are not necessary or useful in every case.

The NHS Choices website has more information on psychosis. 

Patients who have suspected long standing retinal holes do not need to have laser treatment if they don’t have any symptoms.
For more information on retinal holes see the NHS choices website

When discussing treatment for adult schizophrenia with your doctor or specialist nurse, you or your advocate should consider whether medications taken by mouth or longer-acting medications given by injection are most appropriate to you.

The NHS Choices website has more information on the treatment of schizophrenia. 

When you are considering having surgery, you should be informed of your options and be given the chance to discuss the potential benefits and the potential harm of having the procedure. Your age, type of surgery and medical conditions may place you at a higher risk of developing complications or even death. Where this is the case it should be identified and you should be supported in making the right decision for you.

If you are having a surgical procedure, day surgery should be considered as the default option and is suitable in many cases (except complex procedures). Day surgery allows for a quicker recovery with less disruption to you and your home life and also cuts the risk of hospital acquired infections.
The British Association of Day Surgery gives information to help you prepare for day surgery. 

You do not need to come into hospital the day before surgery, if you have had the appropriate preparation, tests and discussions with your doctor beforehand.

Usually you will not need routine tests before surgeries that are minor or intermediate in nature. National guidelines on testing before an operation should indicate when tests are necessary.

You can improve your chances of a speedy recovery after surgery if you get fit, stop smoking, reduce your alcohol intake and in some cases change your diet if you are overweight in the weeks or months before your surgery.

The NHS choices website provides information on preoperative assessments and hospital admissions.
If you are overweight and need to consider losing weight before surgery, the NHS has a decision aid to help you make the right choice on how to achieve this.

Patients who are diagnosed with anterior uveitis (inflammation in the front part of the eye causing pain, redness and blurring) in one eye for the first time will need treatment but do not usually need investigation unless it recurs.
For more information on uveitis see the NHS Choices website

Most vaginal discharge is completely normal and does not require being seen by a healthcare professional.

However, if you are experiencing frequent episodes of vaginal thrush you should have the skin around your vagina examined by a doctor or specialist nurse. They should rule out other conditions such as an allergy or low hormones (vaginal oestrogen), rather than start another course of treatment for thrush.

The NHS choices website gives more information on vaginal discharge and the symptoms and treatment of thrush.