I hope this message finds you well in these difficult times.

The past few days have seen a number of announcements which may help us to envisage what an exit from lockdown looks like. We now know that there is evidence of passing through the peak of the pandemic, albeit a flat one, and that there is still capacity within our health service. Exit from the lockdown will only occur when there is a sustained reduction in hospital admissions and deaths. But there is now a feeling that things are under control and the exit can be planned.

It is clear that social distancing will need to be in place for at least a year and during this time there will be extensive testing, tracing and isolation. This means that we will be hoping to contain the spread of infection while a vaccine or effective treatments are developed. In the meantime, life will be full of stops and starts as we gradually reopen businesses and amenities which will predispose us to a greater risk of infection.

STAYING SAFE

As widespread testing is rolled out, people who are found to be positive for Covid 19 will be isolated for up to 2 weeks. As will anyone that they have contacted and in this way outbreaks of infection should be contained. By this method, it is anticipated that a second wave will be prevented which is critical as the winter approaches and the normal influenza season takes hold.

There will be no mass gatherings for the foreseeable future, including sporting events or conferences of any kind and international travel is unlikely to resume this year to any great extent

Businesses may well have to change the working week in order to enable social distancing  and prevention of a twice a day rush hour. This may mean a 7 day working week with workers being asked to spread their shifts and days through the week. This will enable the economy to get going whilst keeping Covid under control.

Schools may reopen but pupils will be attending in such a way as to reduce class sizes and protect teachers from infection. Inevitably, life will be much slower for some time to come.

BUT WHAT OF HEALTHCARE?

The health service is doing an incredible job of treating Covid patients. However, there is a wider impact on other non Covid patients who have not gained access to medical care in the same way. There is an accumulating backlog of around 2,000,000 patients who will need to be prioritised in the coming months. This will be a significant challenge and will inevitably result in a change in the way we see patients in the future. The increase in remote consultations which is taking place will become a permanent legacy of the Covid pandemic. Medicine has yet to work out how this will play out in terms of assessing patients clinically prior to instigating treatments.

The link between the NHS and the private sector will be sustained. A balance will need to be struck in order that private medicine can develop whilst at the same time nurturing the NHS until Covid 19 is defeated.  Longer waiting times will be the new norm not just in the NHS but also in the private sector.

Stay safe.

As we approach the peak of the coronavirus infection in the UK, it has become clear that admissions to hospital for other conditions such as abdominal pain have declined. Whilst it is imperative to avoid travel at this critical time, it is also necessary that we seek appropriate help for abdominal pain during the pandemic in order to avoid late presentation of surgical conditions.  The majority of general surgical admissions to hospital in normal circumstances are due to the following:

  • nonspecific abdominal pain

  • gallstones

  • appendicitis

  • bowel dysfunction including constipation

  • diverticulitis

Whilst this list is not exhaustive, it accounts for 80% of the conditions which are normally seen on a daily basis by the surgical team.

HOW DO THESE CONDITIONS PRESENT?

The site of abdominal pain often gives a clue as  to the organ from which the pain is arising. For example, gallstones usually present with pain in the upper abdomen, and this pain may travel through to the back or to the right side under the ribs. Appendicitis virtually always presents with pain in the right side of the lower abdomen, sometimes starting initially around the belly button.

Diverticulitis is an inflammation of the colon and is sometimes referred to as left sided appendicitis since the pain is typically on the left side of the lower abdomen.

Constipation, when severe, can cause significant abdominal pain and usually presents with cramping pain across the whole of the lower abdomen. Non specific abdominal pain is so called because there is usually no underlying serous problem and because it can mimic the other causes of abdominal pain.

WHEN DO I NEED TO SEEK HELP FOR ABDOMINAL PAIN DURING THE PANDEMIC?

Contact your GP or call 111 if:

  • abdominal pain persists for more than a few hours and gradually or suddenly increases in severity

  • pain is associated with tenderness to touch

  • the pain is associated with an elevated temperature

  • there is abdominal distension

  • there are associated symptoms including burning when passing urine, your body shaking uncontrollably, heavy rectal bleeding, persistent vomiting or uncontrollable diarrhoea

HOW WILL I BE TREATED IF I GO TO HOSPITAL?

During this pandemic, every effort is being made to avoid hospital admission and so GPs will only send you in if it is deemed absolutely necessary. It is highly likely that you would then be seen by a consultant surgeon whose main aim is to decide if you need surgery.

Most patients are not being admitted for observation currently and so you should expect that you will be sent home with reassurance painkillers, possibly laxatives or even antibiotics.

CT scanning is being widely used to help diagnosis and to determine whether patients require surgery or outpatient observation. If you are diagnosed with uncomplicated appendicitis, you may be treated with antibiotics and early regular review in outpatients rather than surgery.

The majority of patients with gallstones can be managed with painkillers and those with infected gallstones will require antibiotics. Inflammation of the pancreas due to gallstones (pancreatitis) may require hospitalisation as in a few cases this can be life threatening. This significant move away from operative treatment is designed to minimise your chances of contracting Covid 19 whilst on hospital premises.

HOW CAN WE AVOID THESE CONDITIONS?

Many of these conditions are influenced by lifestyle and it is therefore imperative that whilst we are at home for prolonged periods, we maintain our hydration with at least 8 glasses of water per day. It is essential to eat a healthy diet including 8 portions of fruit and vegetables per day, a low saturated fat intake and avoiding excessive alcohol intake. If possible, it is sensible to be active for an hour a day which can be as simple as going for a walk.

In spite of living a healthy lifestyle, surgical problems may still develop and it is important that you seek a medical opinion. Your local hospital is equipped to deal with emergency surgical issues as well as coping with Covid 19 admissions.

Look after yourselves.

Stay safe

 

The latest measures from government are welcome and will definitely save lives in the long run. It is imperative that we all adhere to this as the NHS for the predicted rise in hospital admissions. The private sector has linked up with the NHS and made available its staff, equipment and capacity at this crucial time. It is an absolute priority that all available resources are utilised to save lives and we are all involved in doing that. With the cancellation of all routine clinics and procedures, many patients are finding it difficult to obtain an expert opinion and so doctors are moving towards virtual consultations, either via telephone or videoconferencing.  

Therefore, I am pleased to be able to announce that from Monday 30th March, Alan Woodward Surgical Group will be offering private consultations via telephone and videoconferencing for patients with abdominal pain, bowel problems and hernias

To book an appointment email Karen at karenmedsec@gmail.com or call 07969043507

Stay safe.

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