Wyndham House Surgery

What about a nightcapsule? Parish Magazine Article Feb 2020

For over thirty years Wyndham House has been involved in medical research work. In the 1990s we were part of the Devon Primary Care Research Group and were involved in several important studies that went on to win national recognition. Colin Greaves who worked with us then is now Professor of Psychology Applied to Health at Birmingham University and advises the Government on how to promote healthy lifestyles. We are now mostly involved in larger South West research projects and one of these hit the national press at the end of last year. This was a relatively simple study that asked the question ‘When is the best time to take your blood pressure medication?’ Many of our patients were enrolled in this massive study of almost 20,000 people. The study design was not complicated: those involved were divided into two groups, one to take their blood pressure tablets at bedtime, the other to take their blood pressure tablets on waking. The study ran for 6 years and the results were surprising. There was a significant difference between the two groups. There were a lot less cardiovascular events (heart attacks and strokes) in the bedtime dosing group. Those taking their tablets at bedtime had better blood pressure control, mostly due to a lower blood pressure when sleeping. So a simple small change can make a big difference. We will be encouraging everyone to start taking their blood pressure pills at bedtime and will be changing the instructions on patients’ medications over the next few months. If you are not sure which tablets are for blood pressure please ask us when picking up your next prescription.

Of course, more important than when you take the medication is that you actually take it. If you are likely to forget taking tablets at night then it is much better to stick to a regular morning regime as taking them is better than not taking them at all!

Anthony O’Brien

If you are a carer there is support locally via the Friends of Wyndham House Carer Support Group.  The group meets at 1230H on the first Tuesday of every month at The Lamb Inn.

Contact Trish Jones on 0748 437 7289 or silverwellbeing@gmail.com for more information

There is also help and support available via Devon Carers who have an excellent website

The Silverton Film Club meets at 1430H on the third Wednesday afternoon each month in the Silverton Millenium Hall.  The next film to be shown will be advertised on notice boards around the village

The 2019 awards ceremony honouring  the dedicated staff and volunteers who help deliver Devon’s essential community transport services was organised and held by Devon County Council on 18th July.

Walk this way – Parish Magazine article September 2019

I have just returned from a walking holiday with my family in the Alps. We certainly expended a lot of calories walking on average 5 hours a day at an altitude of 2,500m between a range of mountain huts. In the evenings we ate a variety of lentil dishes (food was mostly transported in by helicopter) and played a lot of cards. We also chatted with fellow walkers until heading to bed early – there was no specific ‘lights out’ time as mostly there were no lights to turn out, electricity being a valuable resource in the mountains. We returned refreshed, reinvigorated and a couple of pounds lighter.

The holiday made me reflect once again on the power that walking has on so many aspects of our health. Joints, muscles, weight and balance are all optimized with regular bipedal activity and now new research has confirmed multiple other benefits as well. Walking alleviates the symptoms and stresses of our increasingly sedentary lives and it helps the intestines by keeping the bowels moving so reducing episodes of constipation. It also has a significant effect on the aging process within our brains with some research suggesting it might even reverse it. Recent studies have looked at Walk & Talk groups (exactly like the one run by walkingforhealth.org.uk meeting at 10.00 AM outside Silverton Millennium Hall on Tuesdays and Wednesdays)) and have found that those participating develop more neural pathways, rather than slowly losing them. This all adds to previous research showing how walking can boost creativity, critical thinking and significantly raise our mood levels.

A few centuries ago Hippocrates wrote that walking was ‘the best medicine’ and there is now a mountain of evidence that he was on to something. Being able to walk on two feet and communicate verbally are probably the two most important features that make humans stand out in the animal kingdom. Exploiting and combining both as a way of protecting our health would seem to be relatively easy to achieve. It can also be incredibly enjoyable with the bonus that any distance at any age will be beneficial. Why not kill two birds with one stone next month by taking the added benefits of a stroll down to one of our Flu Clinics being held this year on the Saturday mornings of 5th & 26th October 9am – 12pm.

For more information about Silverton Walk & Talk go to the Wyndham House Surgery Website, pick up a leaflet at the surgery or contact Wellbeing coordinator Trish Jones on 0748 437 7289 or silverwellbeing@gmail.com

Anthony O’Brien, Wyndham House Surgery

We now have an app that will help you to access information about the surgery, book appointments, order repeat prescriptions etc. without having to sit down at your computer. It is suitable for all ‘smart’ devices e.g. phones, tablets etc. Install it now! Search for ‘Total Medical Hoot’ in your favourite App store , or follow the links below.

Android https://bit.ly/2Rqs3aw

Apple https://apple.co/2MEZOnM

TALKWORKS is the new name for the Depression & Anxiety Service. The rebranding is occuring as the service continues to expand and enable those with mild to moderate mental health difficulties to access help at an earlier point. The new website can be found at TALKWORKS.

This is a counselling service that starts with a telephone consultation and is followed by three free counselling sessions. Wyndham House is now hosting some of these sessions on Fridays. GPs will often suggest patients contact the Depression & Anxiety services for support and we would advise using this link and requesting your most local appointment.

The surgery has been invited to take part in a Welcome research project running over the next three years examining the effect of waiting times on patients. This project is Humanities led rather than a more traditional scientific statistical approach. Our role will be to help with collecting the experiences of patients and staff operating in a rural practice with widely acknowledged excellent access. These will be compared with the experiences of patients in a practice in a deprived community in East London. There are many other strands of this project and you might come across these in and around Exeter over the next few years. For more information click here

“I would like a scan please?” is the opening gambit in many consultations.  It is a simple and direct request but often leads to some complex and difficult conversations.  This is because ordering any test does not come risk free.  The consequences of too many X-rays, ultrasounds, CT and MRI scans are enormous for both individual patients and the NHS as a whole. The problems are more than concerns about excess radiation but more to do with the complications of uncovering things that we were not looking for. These incidental findings almost always turn out to be nothing worrying but only after much time and money is spent on exploring them. MRI scans provide the most detailed imaging available and as a result have the highest ‘incidentaloma’ rate. The chance of a headache being a symptom of a brain tumour is very small (approximately 1 in 1000) however the chance of finding something abnormal on a brain scan can be as great as 1 in 10. This leads to further investigations that have costs for both patients and the NHS. Although medical science has a fantastic understanding of the anatomy, physiology and pathology of the human body we are still a long way from fully explaining everything abnormal we find. Watch, wait and see what happens is a highly valued diagnostic tool; it is the cheapest and most effective treatment strategy we have for almost all minor illnesses and GPs are very skilled at using it.  Most patients prefer this approach rather than taking medicines with their potential to cause side effects.  However, watching and waiting when there is something physical to see or an abnormal test result to consider is much more anxiety provoking. Symptoms are easy for patients to monitor, however abnormal scans and blood results are more difficult to manage. So if a doctor seems reticent about ordering a test that you request it is often much more complicated than it might at first seem.  This is not direct rationing, it is evidence based decision making that is considering the pros and cons of the test. We can now treat many carcinomas very successfully however ‘incidentalomas’ are starting to prove more difficult, more complicated and much more expensive for all.

Anthony O’Brien

Parish Magazine article 2019

Spring has arrived.  Daffodils, cherry blossom and lighter mornings all have a mood enhancing affect.  Suffering from the winter blues is a well recognized clinical phenomenon.  There are lots of theories as to why this cyclical mood pattern persists in a proportion of the population. One proposal is that there were evolutionary advantages of being more sedate and more withdrawn during periods when the weather was cold and the food supply was reduced.  Depressive symptoms can often be described as ‘withdrawing into a cave’ and I suspect this may have some real truth in it.  On reflection it is not surprising that behavioural patterns have survived through evolution.  So we should certainly grasp all the advantages of the new found energy and feel of invigoration that many of us experience at this time of year. 

Certainly at the surgery it is a time for new projects.  The most exciting and most visible of these is our new ‘Bertie’.  This is the car that delivers medication to housebound patients and for the last 12 years it has been the familiar light green Berlingo. However over this winter he started to suffer signs of old age.  In order to keep the service running the Friends of Wyndham House have bought a new blue ‘Bertie’ who many will have already seen motoring around the lanes.  We are indebted to the Friends for funding this amazing service that delivers so much more than medication. Our wonderful volunteer drivers make contact with our elderly more frail patients at least once a month and there are weekly deliveries for those on more complex medications.  This acts as a close liaison between the surgery and our most vulnerable.  The value of social contact, a quick ‘Hello, how are you doing’ has enormous power and positive effects.  It often is the stimulus that nudges those who find themselves in a ‘cave’ towards the entrance. Life is so much better when they can see what is passing by.  The Friends Befriending Service is also staffed by volunteers who are keen to support anyone who needs help to venture further. Trish Jones, the Friends Wellbeing Coordinator, runs this service and if you think you, a friend, or a relative might benefit please do contact Trish directly (0748 437 7289 silverwellbeing@gmail.com)

So Spring is a great time to try something new, develop new friendships, take up new hobbies, get out of our ‘caves’ (we all have one) whether deep or shallow. Jump up, get out and light a metaphorical fire somewhere that will warm yourself and everyone passing by.  All social interactions endue a sense of wellbeing and, as I have written many times before, we underestimate the health giving power of community and connection at our peril.  Cavemen knew a thing or two about surviving and making the most of what was around them.

Anthony O’Brien

Parish Magazine article April 2019