Fall 2004

P e r s p e c t i v e s
Refer patients who smoke to the Smokersí Helpline

Dr. Susan King

I hope you all had a chance for some down time over the summer. Now itís back to the grind again. School starts up, as does the chilly air, the longer nights, too many meetings and, of course, the usual array of fall germs.

by Dr. Susan King

     I hope you all had a chance for some down time over the summer. Now itís back to the grind again. School starts up, as does the chilly air, the longer nights, too many meetings and, of course, the usual array of fall germs.
     When patients come in with their respiratory germs, donít forget to remind the smokers that itís not too late to butt out.
     The Lung Associationís Smokersí Helpline has trained counselors to help smokers break the habit. The NLMA has worked with the Lung Association and developed a fax back form we can use to refer patients for smoking cessation counseling. With the patientís permission, we can send their name and phone number to the Smokersí Helpline counselors who will follow up with the patient and begin a quit program. This is working very well, but we do have to remember to send the names in. And ó donít forget ó kids start smoking often before even age 12.

TIPS AND HINTS
     Looking in the throat and doing a throat swab can be a challenge. It sometimes helps to get the patient to hold his breath ó itís much harder to gag when holding oneís breath and can help make the swab a less trying experience. (Dr. Tom Costello)
     Some studies indicate that zinc lozenges, started within 24 hours after the onset of a sore throat, can lessen the severity of a viral infection. When patients come in having woken that morning with a sore throat itís a good recommendation and may satisfy their desire to take an antibiotic.
     We are all used to epidemics of germs ó there seems to be one causing obesity and it is gaining hold. I find that encouraging people to do even a three-minute walk a day and build from there is helpful. People often are puzzled as to why they are gaining weight. I find it helpful to explain that our metabolism naturally decreases as we age and if we make no changes in our diet or activity level, as we approach middle age we will gain two to three pounds per year.
     Speaking of weight loss, the Atkins fad is still upon us although the press lately has given some time to its downsides. I tell patients that the best weight loss diet is probably the diabetic diet ó it watches carbs and fat. I inform them that whole wheat products are less fattening than white and that can encourage them to eat more whole grains.

HUMOR HELPS
     Ever have patients come in three days after they have run out of their hypertension pills? Iím sure your patients are not much different than mine. Iíd like to get angry, but I havenít found much success that way. I have found a humorous approach useful. I say, in a light-hearted tone: ďDonít tell me, the pill fairy got you didnít she?Ē When they look puzzled, I explain how thereís a pill fairy that gets into medication bottles and makes the bottle look full so that the person doesnít notice it getting emptier every day, until one day you open up the bottle and thereís not one left! They usually get the message that one can see oneís supply shrinking and that itís then they need to call. Itís a way Iíve found to get my opinion across without damaging our relationship and I find it usually works!
     Thereís lotís of experience among the docs in this province. Found something works for you? Fax or e-mail your hint and weíll spread it around (like a pleasant germ).

     Have a good fall.

     Dr. Susan King is a family physician in St. Johnís. Tips and hints may be emailed to nlma@nlma.nf.ca or faxed to 709-726-7525.

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Nexus DEFINED
A connected group or series; a bond, a connection.

Nexus is published quarterly for Newfoundland and Labrador's physicians. It is a forum for the exchange of views, ideas and information for members.