Health Card Services and Schemes
A Medical Card is a plastic card, about the size of a credit card, issued by the HSE. People who hold a Medical Card are entitled to a range of Health Services free of charge. This includes GP visits, prescribed medicines, hospital visits, and a range of other services and benefits. Anyone over the age of 16 years who is ordinarily resident in the State can apply for a Medical Card. Medical card eligibility is based on an assessment of means.
Click to find out more on: http://www.hse.ie/portal/eng/services/list/1/schemes/mc/about/howtoapply/
A GP Visit card will allow some individuals and families to visit their family doctors for free. Patients who are eligible for this scheme must still pay for their prescribed medicines and so are advised to also enroll on the Drugs Payment Scheme.
Click to find out more on: http://www.hse.ie/eng/services/list/1/schemes/mc/gpvc/
Note: From 1st October 2010, Medical Card holders are required to pay a prescription levy on prescription items they receive under the scheme. From 1st January 2018, the charge is €2.00 per dispensed item, with a family limit of €20.00 per month. Pharmacies are obliged to collect this fee on behalf of the HSE.
Click to find out more on: http://www.hse.ie/eng/services/list/1/schemes/mc/prescriptioncharge/
If you do not qualify for a Medical Card, ask us about the Drugs Payment Scheme (DPS). You may be able to save on your monthly medicine costs.
Any Irish resident who does not hold a medical card* is entitled to enroll on the DPS (*those holding GP Visit Cards can enroll). Under the scheme, each individual or family will never pay over €134* from the 1st of Jan 2018(*subject to change by HSE) per calendar month for their prescription medicines.
This doesn’t mean that you are obliged to pay €134 every month. Your pharmacy will keep a running total of the amount you pay for prescriptions and stop charging you once you have hit the €134 mark. It is advisable to remain with the same pharmacy for each calendar month to ensure the total is kept accurately up-to-date.
Click to find out more on: http://www.hse.ie/eng/services/list/1/schemes/drugspaymentscheme/
All those over 70 who wish to apply for this scheme are subject to a means test. Additional consideration will be made for those with high medical expenses who have incomes higher than the normal limits.
Click to find out more on: http://www.hse.ie/eng/services/list/1/schemes/mc/over70s/guidelines.pdf
The HSE provides additional benefits and services to thousands of families and individuals in Ireland. These are provided for in law to make the cost of health and medical care more affordable for all. These include:
- Long Term Illness Scheme:- If you have certain long-term illnesses or disabilities, you may apply to join the Long Term Illness Scheme
- Hepatitis C Services: - If you contracted Hepatitis C from the administration within Ireland of blood or blood products read further
- European Health Insurance Card (EHIC): - EHIC allows the holder to access health care services when travelling to other EU or EEA countries
Click to find out more on these schemes and others:
An important part of managing arthritis is physical activity. It has many health benefits from reducing pain and inflammation, improving joint support and lubrication but it also helps to maintain a healthy body weight control which can help greatly. Did you know that losing 1kg of excess weight decreases stress on your knees by 4kg? By increasing physical activity, you can make a difference to your joints and overall health.
Due to the pain and fatigue and other physical challenges that occur when living with arthritis, the biggest challenge in many cases is the motivation to get your mind exercise-ready and without motivation and goals you won’t get very far.
Cartilage depends on joint movement to absorb nutrients and remove waste so in fact by exercising you’re actually ‘feeding’ or ‘nourishing’ your joints. Exercise can help you improve your health and fitness without hurting those joints.
Along with your current treatment programme, regular, moderate exercise offers a whole host of benefits, including:
- Reduces your joint pain and stiffness
- Helps you maintain bone strength and quality
- Increases your joint range of motion and joint mobility
- Improves your balance
- Gives you more strength and energy to get through the day
- Helps you control your weight
- Makes it easier to get a good night's sleep
- Makes you feel better about yourself and improves your sense of well-being
- Improves your ability to manage stress
- Reduces the risk of other chronic conditions
- Promotes stronger heart and lungs
- Lowers your blood pressure and cholesterol
Exercise will not make your arthritis worse – as long as it is the right sort. There isn’t just one particular exercise or activity that is recommended for all people with arthritis. Choose an activity that you enjoy and that is convenient for you to do. Low-impact exercises, with less weight or force going through your joints, are usually most suitable.
Examples of low-impact activities include:
- Swimming and exercising in water, such as hydrotherapy (with a physiotherapist)
- Yoga, Tai Chi and Pilates
The wrong sort of exercise could put strain on your joints and damage them further. Ask your GP to refer you to a physiotherapist, who will help you work out an appropriate programme depending on the type and severity of your arthritis and your general level of fitness. There are three main types of exercise for people with arthritis:
Walking can be a great form of exercise encompassing all of the above. The Arthritis Ireland Walking Groups are specially designed for people with arthritis and are run in communities across the country. Most of their walking leaders have experience of living with arthritis themselves and this helps foster a supportive and encouraging group spirit. Leaders are trained in techniques needed to facilitate walking groups. They will teach you how to get the most from your walks by looking at things like warm-ups, stretching, posture and clothing. They are also a great source of encouragement.
Benefits of walking in a group:
- Safety and security
- Opportunity to meet other people
- Supportive group format that caters for a range of abilities
- Social interaction and an excuse for a chat!
For more information please contact Arthritis Ireland at www.arthritisireland.ie
The number of people with diabetes in Ireland is growing rapidly. At present there are an estimated 191,000 people with the condition with approximately 30,000 of these undiagnosed.
What is diabetes mellitus?
The term ‘diabetes’ means excessive urination and the word ‘mellitus’ means honey.
Diabetes mellitus is a lifelong condition caused by a lack, or insufficiency of insulin. Insulin is a hormone – a substance of vital importance that is made by your pancreas. Insulin acts like a key to open the doors into your cells, letting sugar (glucose) in. In diabetes, the pancreas makes too little insulin to enable all the sugar in your blood to get into your muscle and other cells to produce energy. If sugar can’t get into the cells to be used, it builds up in the bloodstream. Therefore, diabetes is characterized by high blood sugar levels. Excess sugar is also excreted in the urine, hence the practice, in days gone by, of tasting it to diagnose the condition.
Types of diabetes
There are two main categories of diabetes: Type 1 diabetes tends to occur in childhood or early adult life, and always requires treatment with insulin injections. It is caused by the body’s own immune system destroying the insulin-making cells (beta-cells) of the pancreas. Type 2 diabetes usually develops slowly in adulthood. It is progressive and can sometimes be treated with diet and exercise, but more often Type 2 diabetes may require antidiabetic medicine and/or insulin injections.
If you DON’T have diabetes, your body automatically keeps your blood sugar exactly at the right level. After a meal containing carbohydrates, sugar is absorbed into the blood stream very quickly. The amount of sugar in your blood must not get too high or too low. Two hormones – insulin and glucagon – are produced in the pancreas to ensure the blood sugar is always well controlled no matter how much you eat and how much you exercise.
Knowing the symptoms and risk factors for diabetes is important as non-diagnosis can seriously affect your quality of life. Undiagnosed or poor controlled diabetes can damage your heart, arteries, eyes, nerves and kidneys leading to serious health problems for you and your family to cope with.
You are more at risk of getting Type 2 diabetes if you are:
• Over 40 years of age
• Have a parent or brother/sister with diabetes
• Had diabetes during a pregnancy
• Are overweight for your height
• Do not take 30 minutes of physical activity daily
• Have high blood pressure
• Have high cholesterol
And/or recognise any of these symptoms:
• Blurred vision
• Fatigue, lack of energy
• Extreme thirst
• Frequent trips to the bathroom (urination) especially at night
• Rapid and unexplained weight gain or loss
• Frequent infections
• Numbness, pain or tingling in your hands or feet
The more risk factors or symptoms that you have the more likely you are to have diabetes or pre-diabetes.
If You Are Worried:
If you are concerned why not speak to your GP and tell him/her why you think you may have diabetes. A simple diabetes test will ease any worries you may have.
If you are diagnosed with diabetes, don’t worry. Your doctor will take steps to treat and control your condition. Early detection, effective treatment and good control will help you avoid the more serious health related problems of diabetes and allow you to maintain your quality of life.
If you’ve recently been diagnosed with Multiple Sclerosis then chances are you’ve been experiencing symptoms and getting tests for months now, and more recently your neurologist will have told you that you have MS. You will naturally go through a multitude of emotions from feeling relieved, angry, sad, frustrated or accepting of the news, all of which are normal.
The MS Ireland website will be a valuable resource for you and your family informing you of services and supports in place.
What is MS?
Multiple Sclerosis is a disease of the brain and spinal cord (central nervous system). The central nervous system acts like a switchboard sending electrical messages along the nerves to various parts of the body. These electrical messages instruct the body to perform various tasks, such as movement or thought.
Most healthy fibres are insulated by myelin, a fatty substance which aids the flow of messages. In MS, the myelin breaks down or becomes scarred. This distorts or even blocks the flow of messages, resulting in the many symptoms of MS.
Many people explain MS like a faulty electrical flex on a kettle. If the insulating flex breaks, it exposes the wires underneath making them more vulnerable to damage.
The presence, severity and duration of all MS symptoms vary considerably from person to person. The unpredictable nature of the condition can sometimes make it hard to manage. However, over time, many people begin to notice patterns and triggers to their symptoms, and with appropriate treatment and intervention, many symptoms can be managed quite successfully.
Some of the symptoms of MS are immediately obvious, but no matter what the symptoms are, it is important to alert your GP or Neurologist when a new symptom appears, or an existing symptom changes:
- Reduced mobility
- Changes in sensation
- Memory and concentration problems are often ‘hidden’ symptoms
Managing symptoms is not just about drug treatments, and many people find a healthy lifestyle also helps. A balanced diet, appropriate exercise and keeping stress at a minimum can give your body and mind the best chance to deal with symptoms. Some people with MS find complementary therapies helpful. Many of these therapies promote wellbeing holistically; the focus being on the person and not just the symptoms. Remember to speak to your doctor first before starting any form of alternative therapy.
Managing symptoms is part of the overall management of the effects of MS. Symptoms not only affect the functioning of the body physically, emotionally and cognitively, they can also affect your work, social life and family. It is important that you look at your everyday life and look at any changes you can which will help you manage your MS as successfully as possible.
Living with MS
Managing the various elements in your life and making some of the big decisions can be daunting for anyone, but when living with MS some decisions have extra considerations.
With the changing nature of MS, managing your health, career, family life and social life can be challenging. While MS may not necessarily prevent you from doing the things you always wanted to do, your health will play a bigger part in the decision making process. Compromise, alterations or different courses of action may need to be assessed when considering career, family, travel or other life events. However, these are not all negative. While some people choose to give up work because of stress others may choose to travel more because they want to make the most of their ability.
The best choices you make will be those that take into consideration your desires and your abilities. Talk to friends, family and professionals before making major decisions and draw from the experience of other people with MS, too.
For people with MS, a good lifestyle is very important, too. Keeping yourself as healthy as possible can alleviate some of the symptoms, delay disability, and sustain your mental wellbeing. Managing symptoms for someone with MS is an important feature of staying healthy. By finding ways to deal with symptoms, you can improve your health, reduce stress and maintain independence.
There are a number of health professionals who can help and advise. It is recommended that you keep in touch with your neurologist, as he or she will be able to refer you to others or provide information that will assist you.
Staying healthy is about recognising the way MS affects you and making choices that have a positive impact on your life, and on the lives of those around you.
Ref: MS Ireland
There is a difference between depression with a little ‘d’ – which we all get – and depression with a big ‘D’. Depression with a little ‘d’ is a natural response to having a bad day or hearing sad news. Depression with a big ‘D’ is when your whole energy and concentration is down and you are struggling to focus. It is a mental health condition which affects a person’s thinking, energy, feelings and behaviour. It’s not just having a bad day. If you have symptoms of depression you may not want to talk about it. However, talking about how you feel to your GP or family is a positive first step in learning how to manage Depression.
Symptoms of Depression
What does depression look like?
Depression has eight main symptoms. If you experience five or more of these symptoms, lasting for a period of two weeks or more, you should speak to a GP or mental health professional. The symptoms of depression are:
- Feeling sad, anxious or bored
- Low energy, feeling tired or fatigued
- Under-sleeping or over-sleeping,waking frequently during the night
- Poor concentration, thinking slowed down
- Loss of interest in hobbies, family or social life
- Low self-esteem and feelings of guilt
- Aches and pains with no physical basis, e.g. chest, head or tummy pain associated with anxiety or stress
- Loss of interest in living, thinking about death, suicidal thoughts.
What causes it?
Depression has a number of possible causes. For some people, it happens because of a traumatic life event such as bereavement, relationship breakdown, financial difficulties or bullying. In other situations, the person may have an inherent tendency towards depression, and such genetic factors can be key in the case of bipolar disorder. This mood disorder involves not just periods of depression, but also periods of elation, where the person’s mood is significantly higher than normal. During these periods, a person may have excessive energy with little need for sleep, may have grandiose ideas and may engage in risk-taking behaviour.
What should I do if I’m depressed?
The most important thing to do is speak to a doctor or mental health professional in order to get a correct diagnosis. There are a number of treatments for depression, depending on the cause and severity of symptoms and a professional is best placed to decide which, if any, treatment is most appropriate. Accessing reliable information is also vital. As well as online information booklets and online talks Aware offers free information packs – call 01 661 7211 or email to request one.
Talking through concerns with someone who understands can also be a help: theAware Support Line is available on 1890 303 302 or you can email us for support at Aware support groups can also be a huge help: see our map of support groups for the nearest location to you. Support groups for individuals with depression are available in all 32 counties, with support groups for relatives also offered in some areas.
Main Types of Depression
A person with mild depression typically experiences tiredness, some early morning wakening, indecision, poor concentration and loss of confidence. It is important to note here that the person will not necessarily feel depressed.
Most of the symptoms of depression as listed above are present: the person feels depressed, is extremely fatigued, has marked sleep disturbance and appears to others to be depressed.
In addition to the symptoms of moderate depression, the person’s judgement is impaired in a severe depression – i.e. they have an extremely negative and pessimistic view of their own self-worth and future prospects. Strong suicidal thoughts (or intent) will also be present.
Someone suffering a severe depressive episode may have delusions or false beliefs (e.g. that they are evil, wicked, bankrupt or terminally ill) or may suffer from hallucinations (hearing voices or having visions) with similar themes. When delusions or hallucinations are present, the depression is referred to as a psychotic depression. Such depressions are an extreme extension of the negative thinking that is part of a mild or moderate depression.
Bipolar disorder involves both depressive periods and their opposite, which are known as elations or manic periods. Symptoms of the depressed phase are the same as those of unipolar depression described above:
- Feeling sad, anxious or bored
- Low energy, feeling tired or fatigued
- Under- or over-sleeping, or waking frequently during the night
- Poor concentration, thinking slowed down
- Loss of interest in hobbies, family or social life
- Low self-esteem and feelings of guilt
- Aches and pains with no physical basis, e.g. chest/head/tummy pain associated with anxiety or stress
- Loss of interest in living, thinking about death, suicidal thoughts
- If five or more of the symptoms above are present for a period of two weeks or more, it is most likely a depressive episode and you should talk to a medical professional.
The symptoms of elation (mania) are:
- Feeling elated, enthusiastic, excited, angry, irritable or depressed
- Increased energy, ‘never felt as well’, over-talkative or over-active
- Reduced need for sleep and marked difficulty in getting off to sleep
- Racing thoughts, ‘pressure in the head’, indecision, jumping from one topic to another, poor concentration
- Increased interest in pleasurable activities, new adventures, sex, alcohol, street drugs, religion, music or art.
- Excessive and unrealistic belief in one’s ability, or having grandiose plans
- Being unaware of the physical symptoms of illness such as asthma, having muscle tension at the back of the head or round the shoulders.
- Thinking that one can live forever, taking reckless physical risks or, if angry or distressed, feeling suicidal.
If five or more of these symptoms are present for more than two weeks, it may be a manic episode, and it is advisable to seek professional medical advice.
Don’t forget depression effects a lot of people, it shouldn’t be a taboo subject...talking to someone whether it be a friend, a colleague, a family member, a counsellor or your doctor is the first step – talking really does help.
On marathon - race day
Keep as warm as possible before the start of the marathon; an old jumper/ hat or plastic top that can be discarded just before the marathon starts would be ideal. Ensure you perform an adequate dynamic warm-up prior to the start: this involves easy jogging, short strides and dynamic drills involving heel kicks, high knee running and trunk twists.
Follow this with ‘short duration’ stretches of the main leg muscle groups, i.e. gluts, hips, quadriceps, hamstrings and calf muscles. Remember to keep your body relaxed and warm.
Avoid blisters by wearing ‘Second-Skin’ over vulnerable areas on feet and toes and rub Vaseline on body areas that are repetitively rubbing against your running attire e.g. over nipples. After crossing the finish line, ensure you change out of your running top immediately in order to prevent hypothermia; have a change of warm clothes in your race bag at the finish line, in case you cannot locate your family/friends after the race.
As uncomfortable as it may be, keep moving after you finish; this will help prevent joint stiffness and muscle tightness and therefore minimise the onset of pain. Once showered and changed, spend 10-20 minutes performing static stretches to prevent the onset of muscle soreness the following day. Continue this routine over the next few days. Ice baths can help ease pain in the working leg muscles following the marathon; 5 to 10 minutes maximum duration.
After the marathon
Follow the P.R.I.C.E. protocol if an injury occurs during the marathon or as a result of completion of the race.
- Protect – the injured area e.g. use crutches, protective bracing if appropriate
- Rest – the damaged area to avoid further injury
- Ice – the injured area for 5-10 minutes regularly within the first 48-72 hours to minimize bleeding and reduce pain
- Compress – the injured area to resolve swelling and aid recovery
- Elevate – the injured area to prevent the accumulation of fluid
Allow sufficient time for your body to rest before returning to running; try walking, or pool exercise to aid in recovery in the first week before easing onto land running.
Consult your Chartered Physiotherapist if you need post race recovery advice, or treatment for ‘niggles’ or injuries that may have developed from the exertions of the marathon.
A massage in the week following the marathon will aid your recovery and reduce muscle tightness; speak with your Chartered Physiotherapist for such recommendations.
How to minimise the risk of injury
- As you increase your mileage, muscular aches and ‘niggles’ may occur therefore build up gradually.
- Never increase your mileage by more than 10% in a week; and never increase both speed and distance in the same week.
- If the increasing mileage proves too tough, take an easy day or rest, this will allow your body to refuel and recover.
- Vary your running surface and direction of your runs.
- You don’t have to run all the time; include cross-training into your programme with cycling, rowing and swimming.
- Include resistance & core training into your programme, this will aid in preventing low-back, hip and leg/foot injuries.
- As your fitness improves it will feel more natural to train more often, and enhance your chances of enjoying the marathon experience.
- Replace running shoes regularly; look under the soles for wear and the mid-sole for over- compression. It’s better to vary between 2 pairs during your preparation. Go to a specialist sports shop for advice on the best running shoe for your foot type, it’s an essential expense!
- Increased back/leg aches and pains may be a sign that your running shoes need to be changed.
- Orthotics (permanent insoles) are often used by runners to help prevent common running injuries. Check with your local Chartered Physiotherapist for a biomechanical assessment to ascertain if you require such insoles in your running shoes.
- Warm up adequately with easy running to prepare your joints and muscles for your race pace, include stride outs, high knee lifts, heel kicks and trunk twisting.
- Perform static sustained stretches after running to minimise muscle soreness and joint stiffness. This helps to prepare your body for your next running session.
- Keep a training diary. This is a useful way of monitoring last years’ form and your training prior to an injury. Use the information to prevent the same pitfalls and to plan your next running programme.
- Never run if you feel unwell; do not attempt to catch-up on lost mileage after illness/injury. This can cause further damage and result in a longer period off running. Better 3 to 4 days of rest than 3 to 4 weeks of frustration!
Quick summary and recap
Fluid lost in sweat must be replaced otherwise your body becomes dehydrated (short of water) and therefore less efficient. Dehydration can lead to fatigue, dizziness, loss of concentration and in extreme cases, death. Rehydrate gradually after the race.
Ensure you are well hydrated before the event. Typically you should drink between 400-800ml per hour during most forms of exercise. A sports drink containing a combination of electrolytes and carbohydrate is ideal to help replace what you loose through sweat and enables a faster route for carbohydrates to reach your working muscles. Hyponatraemia (water intoxication) is the presence of abnormally low sodium concentrations in the blood due to drinking excessive amounts of fluid. Therefore drink as your thirst indicates.
Recreational runners participating in marathons taking longer than 4 hours are most at risk. You should avoid drinking so much that you gain weight during exercise.
Nutrition: Gradually increase your intake of complex carbohydrates 2-3 days before the marathon e.g. wholemeal rice, pasta, bread. This increases your pre-race muscle glycogen stores, and prevents ‘hitting-the-wall’. Ensure you eat a high carbohydrate-protein-combined snack e.g. cereal bar, banana, skimmed milk; within 20-30 minutes after completing your race or faster work-out session. This will kick start the replacement of muscle glycogen stores. Eat a balanced meal within 2 hours after your race.
Ref: Irish Society of Chartered Physiotherapists
If you or someone you know has been diagnosed with breast cancer, the Irish Cancer society can provide the information you need, whether you're making a decision about treatment, looking for support or need to understand the basics.
Breast Cancer is now the second most common cancer in Ireland. It affects over 2,000 women in Ireland every year. Breast cancer is rare in women under the age of 30 and occurs more often in women over the age of 50. Men also develop breast cancer but this is very rare with about 16 men developing breast cancer each year in Ireland.
Types of Breast Cancer
Invasive ductal breast cancer
This is the most common type of breast cancer (also known as infiltrating or infiltrating ductal carcinoma). It starts developing in the milk ducts of your breast, but breaks out of the duct tubes, and invades, or infiltrates the surrounding tissue of the breast. Over time, invasive ductal carcinoma can spread to the lymph nodes and possibly to other areas of the body. Invasive ductal carcinoma accounts for about 8 out of 10 of all invasive breast cancers. Although this can affect women at any age, it is more common as women grow older.
DCIS is an early form of breast cancer. You may hear it described as a pre-cancerous, intraductal or non-invasive cancer, which means the cancer cells are inside the milk ducts or ‘in situ’ and have not developed the ability to spread either within or outside the breast.
Invasive lobular breast cancer
Invasive lobular breast cancer starts in cells that make up the lobules at the end of the ducts. Breast tissue is made up of ducts and lobules where milk is made, stored and carried through to the nipple during breastfeeding. Invasive lobular breast cancer is uncommon, and affects about 10-15% of all women with breast cancer. It can occur at any age, but more commonly affects women in the 45-55 year age group. Men can also get invasive lobular breast cancer but this is very rare. It is generally no more serious than other types of breast cancer. However, it is sometimes found in both breasts at the same time and there is also a slightly greater risk of it occurring in the opposite breast at a later date.
Inflammatory breast cancer
Inflammatory breast cancer is so called because the overlying skin of the breast has a reddened appearance – similar to that seen with some infections of the breast. In patients with inflammatory breast cancer, the reddened appearance is caused by breast cancer cells blocking tiny channels in the breast tissue called lymph channels. The lymph channels are part of the lymphatic system involved in the body’s defence against infections. Inflammatory breast cancer is a rare type of breast cancer, accounting for only 1-2% of all breast cancers.
Paget's disease of the breast
Paget's disease of the breast is an uncommon form of breast cancer. This type of breast cancer starts in the breast ducts and spreads to the skin of the nipple and the areola the dark circle around the nipple. It occurs in around 1% of all women with breast cancer. Men can also get Paget´ disease but this is very rare.
Male breast cancer
Breast cancer in men is uncommon, with approximately 16 men diagnosed each year.
Hereditary breast cancer
Hereditary breast cancer occurs when a faulty gene is passed on from either parent. This greatly increases the likelihood that cancer will develop but people can carry such genes and not develop breast cancer.
Breast cancer screening
Breast screening involves a mammogram x-ray of the breasts, which can detect early signs of cancer before it can be seen or felt. Screening has been proven to reduce the number of deaths from breast cancer, as the disease is very treatable if detected early. BreastCheck, the National Breast Screening Programme, offers free mammograms to women aged 50-64. The programme invites eligible women, on an area by area basis, for free screening every two years. You can register for BreastCheck by calling freephone 1800 45 45 55.
What to do if you find something
If you do notice any change in your breasts, see your GP as soon as possible. Remember that most breast changes are not cancer and are harmless. When your GP examines your breasts s/he may be able to reassure you that there is nothing to worry about. If the change could be connected with your hormones, your GP may ask you to come back at a different stage in your menstrual cycle. Alternatively, you may be sent to a breast clinic for a more detailed examination. Don’t worry that you may be making an unnecessary fuss and remember that nine out of ten breast lumps are harmless.
Questions to Ask your Doctor
If your GP refers you for investigation or tests, ask
- Why are you referring me for investigation?
- Can I be referred to a specialist breast clinic?
- How quickly will I be seen?
- Is my referral urgent or non-urgent?
- Which tests will I need (ultrasound, mammogram, biopsy) and why? Ask about Triple Assessment.
If your GP does not refer you for tests, ask:
- Can you explain why you’ve decided not to refer me to a breast specialist?
- How can you be sure I don’t have breast cancer?
If you are diagnosed with breast cancer, ask your specialist doctor or breast care nurse:
- What is the type and extent of the breast cancer?
- What’s my prognosis?
- What are my treatment options and how soon can they start?
- Should I continue taking HRT or the Pill?
- Are there any changes I should make to make to my lifestyle (diet, exercise, smoking)?
- Will I be able to carry on working?
- Are my female relatives at a higher than average breast cancer risk?
- Can I have tests to find out if the cancer has spread to other parts of my body?
- Are there any clinical trials that I might be able to participate in?
- What services does this hospital provide to help me through this?
- Who can I telephone later if I’m worried about diagnosis and treatment?
The aim of the treatment is to stop any spread of the cancer and, if possible to remove all cancer from the body. In deciding on the most suitable treatment, your Doctor will consider the size of the tumour, the type of breast cancer and whether the tumour had spread to the lymph nodes or other parts of the body. The lymph nodes in the armpit are of particular importance. Finding out if the cancer has gone to the lymph nodes is important in planning adjuvant (additional) treatment such as hormone therapy or chemotherapy.
In specialist breast units, plans and recommendations about treatment are discussed by your specialists at a team meeting. These include:
- the surgeon (surgical oncologist)
- medical oncologist – doctor who prescribes anti-cancer drug therapy
- radiation oncologist – doctor who prescribes radiotherapy
- radiologist – doctor who reads x-rays
- pathologist – doctor who looks at the cells in the lab to diagnose cancer
- breast care nurses
Surgery, radiotherapy, hormone therapy and chemotherapy may be used alone on in combination to treat breast cancer. Surgery and radio therapy are referred to as local treatments because they treat only the area where the cancer has occurred.
Chemotherapy and hormone therapy are called systemic treatments because they treat the whole body.
Your doctor will plan your treatment by taking into consideration a number of factors, including your age, whether or not you have had the menopause, your general health, the type and size of the tumour and whether it has spread beyond the breast. You may find that other women at the hospital are having different treatments to you. Remember every patients treatment is planned on an individual basis.
In Ireland, prostate cancer is the second most common cancer in men, after skin cancer. Each year over 3,000 men are diagnosed with prostate cancer here. This means that 1 in 8 men will be diagnosed with prostate cancer during their lifetime. Although there are many men with this disease, most men do not die from it.
The prostate gland is found only in men. It is a small gland about the size of a walnut. It sits at the base of the bladder and in front of the rectum (back passage). The tube that drains urine from the bladder (urethra) runs down through the centre of the prostate gland, letting urine flow out of the body through the penis. When doctors check the prostate gland, they often measure levels of this protein in your blood. This is called the PSA test.
PSA blood test
This is a blood test which measures a protein made by the prostate gland called prostate specific antigen (PSA). The level of PSA in the blood stream can rise if you have prostate cancer but it can rise for other reasons as well, so a raised PSA does not necessarily mean you have prostate cancer. The normal level of PSA changes as you get older. If the PSA level is raised above normal for your age range it will need to be repeated after six weeks to see if it remains raised. Your GP will also examine your prostate (called a digital rectal exam, or DRE) to see if it feels abnormal, as this can help to diagnose prostate cancer.
A raised PSA can only indicate that a man may have a problem with his prostate gland that needs further investigation. Two out of three men with a raised PSA who do proceed to prostate biopsy do not have prostate cancer, and some men with prostate cancer do not have a raised PSA level.
What are prostate urinary symptoms?
Problems passing urine is a common complaint for men as they grow older. Symptoms may include some or all of the following:
- A slow flow of urine
- Trouble starting or stopping the flow
- Passing urine more often, especially at night
- Pain when passing urine
- Blood in the urine or semen
- Feeling of not emptying your bladder fully
These symptoms may be caused by prostate cancer or they may be caused by other conditions, such as a harmless (benign) growth of the prostate gland called benign prostatic hyperplasia.
It is also important to understand that early prostate cancer may not cause urinary symptoms, or any symptoms at all. It is not safe for you to assume that because you have no prostate urinary symptoms that you do not have prostate cancer. Visit your doctor if you are worried.
Digital rectal exam (DRE)
This involves your doctor putting a gloved finger into your back passage to feel the size and texture of your prostate. The test may be a little uncomfortable or embarrassing, but it is quick. Your GP will be looking for any abnormalities like an area of hardening or a lump on the prostate or if the prostate feels large.
If the prostate gland feels abnormal your GP will refer you to a urology department for further tests, even if your PSA blood test is normal.
Further tests for prostate cancer for many men are often done at Rapid Access Prostate Clinics, which are special clinics set up to reduce waiting times for prostate cancer testing.
Your doctor will consider your PSA level along with your DRE result, any risk factors or other health problems you have as well as any previous biopsy results before discussing the next step with you.
So what is prostate cancer?
Prostate cancer happens when the normal cells in the prostate gland change and grow to form a mass of cells called a tumour. These cancer cells can affect how the prostate works.
They may not grow at all or else grow slowly during a man’s lifetime. Many men never develop problems or symptoms from their prostate cancer. In some, prostate cancer grows more quickly and needs treatment to prevent it spreading outside of the prostate gland. In most cases prostate cancer can be cured or kept under control. Prostate cancer most often occurs in men in their fifties and onwards. It can occur on rare occasions in men in their late forties. The risk of developing prostate cancer rises with age.
Types of Prostate Cancer:
Early Prostate Cancer (localised)
Prostate cancer is most often diagnosed in the early stages, before it has begun to spread beyond the prostate gland. Early prostate cancer, often called localised prostate cancer, means it is confined to the prostate gland only. It has not spread outside of the gland, it is often so small is cannot be felt by the doctor on examination of the back passage and it may even have no symptoms which is when a PSA test can determine a need for further tests.
There are several treatment options available to treat early prostate cancer, most of which aim to cure the cancer. Sometimes a doctor might suggest having no treatment straight away, but instead they will monitor the cancer regularly to see if treatment becomes necessary. This is called active surveillance.
Locally advanced prostate cancer
Locally advanced prostate cancer is where the cancer has spread through the outer shell of the prostate gland and into surrounding tissues, but has not yet spread to other parts of the body.
Treatment options will depend on how far the prostate cancer has spread. The treatment may be aimed at getting rid of the cancer or else aimed at keeping it under control.
Advanced prostate cancer (metastatic)
Advanced prostate cancer means the cancer has spread beyond the prostate gland and surrounding tissue and has spread through the blood stream or lymph nodes (lymph glands) to other areas of the body like the bones, or in rare cases the lung, brain or liver. This is also called metastatic or secondary prostate cancer. This cancer can also happen in a small number of men who have been treat for localised prostate cancer where the cancer has now come back.
If you are diagnosed with advanced prostate cancer you may be offered treatment options which help to keep your prostate cancer under control for many months and often years.
Call the National Cancer Helpline - Freephone 1800 200 700 to talk to a specialist cancer nurse
Around 350,000 Irish people are at risk of developing Type 2 diabetes over the next 20 years and do not even know it. Dr Anna Clarke, Health Promotion & Research Officer, Diabetes Ireland said "Type 2 diabetes is an epidemic that can only be controlled by individuals identifying their own risk profile and taking action to prevent, or at least delay its onset, through making healthier lifestyle choices today. Each day, I see people with diabetes who would love to tell others to take action now and protect their future health".
Below are some guidelines for those NOT using insulin as treatment.
Before exercising consider
It is important that you choose the kind and amount of exercise that is right for you and that you will enjoy. Before you begin an exercise programme, you should consider your general health, your current physical fitness and how well your diabetes is controlled. Discuss your choice of exercise with your diabetes care team. If you have complications from diabetes or other health problems, there may be some sports that are more suitable for you than others.
Benefits of exercise
- It will lower your blood glucose
- Your treatment will work more effectively
- You may lose some weight
- Exercise will strengthen your muscles and joints
- Exercise also lowers your blood pressure and can help with cholesterol management, both of which are good for your heart.
- Being in good shape will increase your self-confidence and help you feel good about yourself.
If your diabetes is well controlled, you should be able to participate in the same kind of physical activities as people without diabetes, but remember that these activities can lower your blood glucose. Although this may sound good, given that type 2 diabetes is characterised by high blood glucose, it is possible for your blood glucose to go too low if you are taking certain kinds of diabetes medicines. Your doctor will advise you if this is a possibility with your treatment. The extent to which your blood glucose is affected will also depend on the duration and intensity of the exercise. It differs from person to person. Try to learn how your body responds to different kinds of physical activities.
When physically active
When you are physically active, your body burns glucose faster and can lower your blood glucose. Some diabetes medicines can increase the risk of hypoglycaemia (low blood glucose) under these circumstances. If you are taking such medicines, you should test your blood glucose before the exercise session. You’ll usually need to eat more before – and maybe also during and after – exercise.
Long periods of exercise
When you exercise for a long period of time (greater than 60minutes), it is usually necessary to eat extra food (particularly carbohydrates), especially if you take diabetic medicines. You’ll also need extra water and fuel every 15 to 30 minutes. Juice, or other sugary soft drinks work well. There are no fixed rules, so you might try some different combinations to see what’s best for you.
Precautions during exercise
Take some sugar, biscuits or juice with you when you exercise. Take your diabetes identification card. It has information about what to do if your blood glucose becomes so low that you need help. If you are exercising with other people or have a coach, you should tell them that you have diabetes, what the symptoms are when you have low blood glucose and what they should do if you suddenly need their help. Tell them where you keep fast-acting sugar/ glucose. Make sure you use the right footwear for your particular type of exercise.
Precautions after exercise
It’s a good idea to test your blood sugar after exercise. If it is normal or low, you should eat some more carbohydrates. Be aware that hypoglycaemia can develop several hours after a hard exercise session if you are taking some kinds of diabetes medicine. If you are taking such treatments and you exercise late in the day, you should be particularly aware of hypoglycaemia during the night and eat an extra large carbohydrate based snack at bedtime. You may also need to eat extra foods rich in carbohydrate, such as pasta, the following day.
Living in Ireland we may feel we do not need to worry about protecting our skin from the sun, but the sun here can burn just as much as when you are overseas.
Overexposure to the sun is associated with:
- Accelerated ageing
- Skin cancer
The Australian saying 'Slip, Slop, Slap' - Slip on a Shirt, Slop on a Hat, Slap on some sun cream is easy, excellent advise in the sun. It is designed to reduce exposure and minimize the risks involved. Other good advice is to avoid exposure to the sun when it as it’s strongest - from 12 noon to 3pm and reapply sun cream after being in water.
What sun cream should I use?
All sunscreens carry a Sun Protection Factor (SPF). This is followed by a number: 15, 25, 50, etc. So, what does this mean? The higher the SPF value, the longer the user will be able to stay in the sun without visibly burning. As an example, if someone would normally start to burn after 5 minutes in the sun unprotected, by using an SPF15 sun-cream they should be able to stay out for 75 minutes without visibly burning.
What about children?
Remember children get burnt very easily and they should wear sensible clothing to cover up well while playing outdoors. Newborn babies should not be exposed to sunlight at all until they are at least 6 months old. After that age, and depending on their skin type, short periods of unprotected exposure (a couple of minutes at a time) may be introduced. Make sure that babies wear a wide-rimmed sun hat that shades the neck, ears and face. Alternatively, use a parasol for protection. Use a broad-spectrum sun cream that filters out both UVA and UVB radiation.
As children become older and more active it is important to keep applying sun lotions especially if they are in and out of water. Again, keeping covered with a light T-shirt will help but you will need to apply lotion underneath for better protection.
What to do if you get burnt?
If you are do get burnt, drink plenty of fluids and use the after sun creams to lessen the effects. If you go to bed, make sure someone is aware you are not feeling well.
If a person is severely dehydrated, especially children, seek medical assistance.